|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$126.20
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna American Axle |
$82.03
|
| Rate for Payer: Aetna Commercial |
$107.27
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$10.73
|
| Rate for Payer: BCN Commercial |
$10.73
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$100.96
|
| 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: Health Alliance Plan Medicare Advantage |
$37.22
|
| 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: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$39.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Nomi Health Commercial |
$111.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$107.27
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health SBD |
$79.51
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.88
|
| Rate for Payer: UHC Core |
$58.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$58.88
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: VA VA |
$37.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.65
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,555.17
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$197.84 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$2,310.86
|
| Rate for Payer: Aetna Commercial |
$3,021.89
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,310.86
|
| 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 |
$197.84
|
| Rate for Payer: BCN Commercial |
$197.84
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cofinity Advantage |
$2,488.62
|
| Rate for Payer: Cofinity Commercial |
$3,057.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,844.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$3,199.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,488.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,666.38
|
| 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 |
$3,021.89
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,666.38
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$3,021.89
|
| 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 |
$2,239.76
|
| 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) |
$2,310.86
|
| Rate for Payer: UHC Core |
$1,852.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$1,397.18
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,315.41
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,666.38
|
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,555.17
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,564.27 |
| Max. Negotiated Rate |
$3,199.65 |
| Rate for Payer: Aetna American Axle |
$2,310.86
|
| Rate for Payer: Aetna Commercial |
$3,021.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,310.86
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cofinity Advantage |
$2,488.62
|
| Rate for Payer: Cofinity Commercial |
$3,057.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,844.14
|
| Rate for Payer: Healthscope Commercial |
$3,199.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,488.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,666.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,021.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,666.38
|
| Rate for Payer: PHP Commercial |
$3,021.89
|
| Rate for Payer: Priority Health SBD |
$2,239.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,564.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,666.38
|
|
|
HC IR REVASC IVT W ANGIO UNILAT COMPLEX INITIAL VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37256
|
| Hospital Charge Code |
36100637
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,238.21 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna American Axle |
$9,215.54
|
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,924.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
| Rate for Payer: UMR Bronson Commercial |
$6,238.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W ANGIO UNILAT COMPLEX INITIAL VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37256
|
| Hospital Charge Code |
36100637
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna American Axle |
$9,215.54
|
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,924.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: UMR Bronson Commercial |
$5,245.77
|
| Rate for Payer: VA VA |
$5,671.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W ANGIO UNILAT SF INITIAL VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37254
|
| Hospital Charge Code |
36100636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna American Axle |
$9,215.54
|
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,924.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: UMR Bronson Commercial |
$5,245.77
|
| Rate for Payer: VA VA |
$5,671.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W ANGIO UNILAT SF INITIAL VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37254
|
| Hospital Charge Code |
36100636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,238.21 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna American Axle |
$9,215.54
|
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,215.54
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Advantage |
$9,924.42
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,924.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: Priority Health SBD |
$8,931.98
|
| Rate for Payer: UMR Bronson Commercial |
$6,238.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W STENT UNILAT COMPLEX INIT VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37260
|
| Hospital Charge Code |
36100639
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,652.95 |
| Max. Negotiated Rate |
$25,881.03 |
| Rate for Payer: Aetna American Axle |
$18,691.85
|
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,129.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,567.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
| Rate for Payer: UMR Bronson Commercial |
$12,652.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,567.53
|
|
|
HC IR REVASC IVT W STENT UNILAT COMPLEX INIT VESSEL
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37260
|
| Hospital Charge Code |
36100639
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$18,691.85
|
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,129.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,567.53
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$10,639.98
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,567.53
|
|
|
HC IR REVASC IVT W STENT UNILAT SF INITIAL VESSEL
|
Facility
|
IP
|
$28,756.70
|
|
|
Service Code
|
CPT 37258
|
| Hospital Charge Code |
36100638
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,652.95 |
| Max. Negotiated Rate |
$25,881.03 |
| Rate for Payer: Aetna American Axle |
$18,691.85
|
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,129.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,567.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
| Rate for Payer: UMR Bronson Commercial |
$12,652.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,567.53
|
|
|
HC IR REVASC IVT W STENT UNILAT SF INITIAL VESSEL
|
Facility
|
OP
|
$28,756.70
|
|
|
Service Code
|
CPT 37258
|
| Hospital Charge Code |
36100638
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$18,691.85
|
| Rate for Payer: Aetna Commercial |
$24,443.19
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,691.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cash Price |
$23,005.36
|
| Rate for Payer: Cofinity Advantage |
$20,129.69
|
| Rate for Payer: Cofinity Commercial |
$24,730.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$25,881.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,129.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,567.53
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,443.19
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,567.53
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$24,443.19
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$18,116.72
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$10,639.98
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,567.53
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$11,244.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,947.36 |
| Max. Negotiated Rate |
$10,119.60 |
| Rate for Payer: Aetna American Axle |
$7,308.60
|
| Rate for Payer: Aetna Commercial |
$9,557.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,308.60
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cofinity Advantage |
$7,870.80
|
| Rate for Payer: Cofinity Commercial |
$9,669.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,995.20
|
| Rate for Payer: Healthscope Commercial |
$10,119.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,870.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,433.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,557.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,433.00
|
| Rate for Payer: PHP Commercial |
$9,557.40
|
| Rate for Payer: Priority Health SBD |
$7,083.72
|
| Rate for Payer: UMR Bronson Commercial |
$4,947.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,433.00
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,244.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,160.28 |
| Max. Negotiated Rate |
$10,119.60 |
| Rate for Payer: Aetna American Axle |
$7,308.60
|
| Rate for Payer: Aetna Commercial |
$9,557.40
|
| Rate for Payer: Aetna Medicare |
$5,622.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,308.60
|
| Rate for Payer: BCBS Complete |
$4,497.60
|
| Rate for Payer: BCBS Trust/PPO |
$8,022.52
|
| Rate for Payer: BCN Commercial |
$8,022.52
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cash Price |
$8,995.20
|
| Rate for Payer: Cofinity Advantage |
$7,870.80
|
| Rate for Payer: Cofinity Commercial |
$9,669.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,995.20
|
| Rate for Payer: Healthscope Commercial |
$10,119.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,870.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,433.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,995.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,557.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,433.00
|
| Rate for Payer: PHP Commercial |
$9,557.40
|
| Rate for Payer: Priority Health SBD |
$7,083.72
|
| Rate for Payer: UMR Bronson Commercial |
$4,160.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,433.00
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,336.90
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,194.65 |
| Max. Negotiated Rate |
$10,203.21 |
| Rate for Payer: Aetna American Axle |
$7,368.98
|
| Rate for Payer: Aetna Commercial |
$9,636.36
|
| Rate for Payer: Aetna Medicare |
$5,668.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,368.98
|
| Rate for Payer: BCBS Complete |
$4,534.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,301.95
|
| Rate for Payer: BCN Commercial |
$4,301.95
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cofinity Advantage |
$7,935.83
|
| Rate for Payer: Cofinity Commercial |
$9,749.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,069.52
|
| Rate for Payer: Healthscope Commercial |
$10,203.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,935.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,502.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,069.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,636.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,502.67
|
| Rate for Payer: PHP Commercial |
$9,636.36
|
| Rate for Payer: Priority Health SBD |
$7,142.25
|
| Rate for Payer: UMR Bronson Commercial |
$4,194.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,502.67
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,336.90
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,988.24 |
| Max. Negotiated Rate |
$10,203.21 |
| Rate for Payer: Aetna American Axle |
$7,368.98
|
| Rate for Payer: Aetna Commercial |
$9,636.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,368.98
|
| Rate for Payer: Cash Price |
$9,069.52
|
| Rate for Payer: Cofinity Advantage |
$7,935.83
|
| Rate for Payer: Cofinity Commercial |
$9,749.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,069.52
|
| Rate for Payer: Healthscope Commercial |
$10,203.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,935.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,502.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,636.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,502.67
|
| Rate for Payer: PHP Commercial |
$9,636.36
|
| Rate for Payer: Priority Health SBD |
$7,142.25
|
| Rate for Payer: UMR Bronson Commercial |
$4,988.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,502.67
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,367.36
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,241.64 |
| Max. Negotiated Rate |
$6,630.62 |
| Rate for Payer: Aetna American Axle |
$4,788.78
|
| Rate for Payer: Aetna Commercial |
$6,262.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,788.78
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cofinity Advantage |
$5,157.15
|
| Rate for Payer: Cofinity Commercial |
$6,335.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.89
|
| Rate for Payer: Healthscope Commercial |
$6,630.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,157.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,525.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,262.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.52
|
| Rate for Payer: PHP Commercial |
$6,262.26
|
| Rate for Payer: Priority Health SBD |
$4,641.44
|
| Rate for Payer: UMR Bronson Commercial |
$3,241.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,525.52
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,367.36
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,725.92 |
| Max. Negotiated Rate |
$6,630.62 |
| Rate for Payer: Aetna American Axle |
$4,788.78
|
| Rate for Payer: Aetna Commercial |
$6,262.26
|
| Rate for Payer: Aetna Medicare |
$3,683.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,788.78
|
| Rate for Payer: BCBS Complete |
$2,946.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,716.78
|
| Rate for Payer: BCN Commercial |
$3,716.78
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cash Price |
$5,893.89
|
| Rate for Payer: Cofinity Advantage |
$5,157.15
|
| Rate for Payer: Cofinity Commercial |
$6,335.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.89
|
| Rate for Payer: Healthscope Commercial |
$6,630.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,157.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,525.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,893.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,262.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.52
|
| Rate for Payer: PHP Commercial |
$6,262.26
|
| Rate for Payer: Priority Health SBD |
$4,641.44
|
| Rate for Payer: UMR Bronson Commercial |
$2,725.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,525.52
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,666.35
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,686.55 |
| Max. Negotiated Rate |
$11,399.72 |
| Rate for Payer: Aetna American Axle |
$8,233.13
|
| Rate for Payer: Aetna Commercial |
$10,766.40
|
| Rate for Payer: Aetna Medicare |
$6,333.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,233.13
|
| Rate for Payer: BCBS Complete |
$5,066.54
|
| Rate for Payer: BCBS Trust/PPO |
$10,334.49
|
| Rate for Payer: BCN Commercial |
$10,334.49
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cofinity Advantage |
$8,866.44
|
| Rate for Payer: Cofinity Commercial |
$10,893.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,133.08
|
| Rate for Payer: Healthscope Commercial |
$11,399.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,866.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,499.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,133.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,766.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,499.76
|
| Rate for Payer: PHP Commercial |
$10,766.40
|
| Rate for Payer: Priority Health SBD |
$7,979.80
|
| Rate for Payer: UMR Bronson Commercial |
$4,686.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,499.76
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,666.35
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,573.19 |
| Max. Negotiated Rate |
$11,399.72 |
| Rate for Payer: Aetna American Axle |
$8,233.13
|
| Rate for Payer: Aetna Commercial |
$10,766.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,233.13
|
| Rate for Payer: Cash Price |
$10,133.08
|
| Rate for Payer: Cofinity Advantage |
$8,866.44
|
| Rate for Payer: Cofinity Commercial |
$10,893.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,133.08
|
| Rate for Payer: Healthscope Commercial |
$11,399.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,866.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,499.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,766.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,499.76
|
| Rate for Payer: PHP Commercial |
$10,766.40
|
| Rate for Payer: Priority Health SBD |
$7,979.80
|
| Rate for Payer: UMR Bronson Commercial |
$5,573.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,499.76
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,980.59
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,172.82 |
| Max. Negotiated Rate |
$12,582.53 |
| Rate for Payer: Aetna American Axle |
$9,087.38
|
| Rate for Payer: Aetna Commercial |
$11,883.50
|
| Rate for Payer: Aetna Medicare |
$6,990.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,087.38
|
| Rate for Payer: BCBS Complete |
$5,592.24
|
| Rate for Payer: BCBS Trust/PPO |
$8,334.63
|
| Rate for Payer: BCN Commercial |
$8,334.63
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cofinity Advantage |
$9,786.41
|
| Rate for Payer: Cofinity Commercial |
$12,023.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,184.47
|
| Rate for Payer: Healthscope Commercial |
$12,582.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,786.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,485.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,184.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,883.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,485.44
|
| Rate for Payer: PHP Commercial |
$11,883.50
|
| Rate for Payer: Priority Health SBD |
$8,807.77
|
| Rate for Payer: UMR Bronson Commercial |
$5,172.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,485.44
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,980.59
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,151.46 |
| Max. Negotiated Rate |
$12,582.53 |
| Rate for Payer: Aetna American Axle |
$9,087.38
|
| Rate for Payer: Aetna Commercial |
$11,883.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,087.38
|
| Rate for Payer: Cash Price |
$11,184.47
|
| Rate for Payer: Cofinity Advantage |
$9,786.41
|
| Rate for Payer: Cofinity Commercial |
$12,023.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,184.47
|
| Rate for Payer: Healthscope Commercial |
$12,582.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,786.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,485.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,883.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,485.44
|
| Rate for Payer: PHP Commercial |
$11,883.50
|
| Rate for Payer: Priority Health SBD |
$8,807.77
|
| Rate for Payer: UMR Bronson Commercial |
$6,151.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,485.44
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,735.72
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,403.72 |
| Max. Negotiated Rate |
$6,962.15 |
| Rate for Payer: Aetna American Axle |
$5,028.22
|
| Rate for Payer: Aetna Commercial |
$6,575.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,028.22
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cofinity Advantage |
$5,415.00
|
| Rate for Payer: Cofinity Commercial |
$6,652.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,188.58
|
| Rate for Payer: Healthscope Commercial |
$6,962.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,415.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,801.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,575.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,801.79
|
| Rate for Payer: PHP Commercial |
$6,575.36
|
| Rate for Payer: Priority Health SBD |
$4,873.50
|
| Rate for Payer: UMR Bronson Commercial |
$3,403.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,801.79
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,735.72
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,862.22 |
| Max. Negotiated Rate |
$6,962.15 |
| Rate for Payer: Aetna American Axle |
$5,028.22
|
| Rate for Payer: Aetna Commercial |
$6,575.36
|
| Rate for Payer: Aetna Medicare |
$3,867.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,028.22
|
| Rate for Payer: BCBS Complete |
$3,094.29
|
| Rate for Payer: BCBS Trust/PPO |
$5,133.27
|
| Rate for Payer: BCN Commercial |
$5,133.27
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cash Price |
$6,188.58
|
| Rate for Payer: Cofinity Advantage |
$5,415.00
|
| Rate for Payer: Cofinity Commercial |
$6,652.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,188.58
|
| Rate for Payer: Healthscope Commercial |
$6,962.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,415.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,801.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,188.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,575.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,801.79
|
| Rate for Payer: PHP Commercial |
$6,575.36
|
| Rate for Payer: Priority Health SBD |
$4,873.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,862.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,801.79
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,623.73
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,670.78 |
| Max. Negotiated Rate |
$11,361.36 |
| Rate for Payer: Aetna American Axle |
$8,205.42
|
| Rate for Payer: Aetna Commercial |
$10,730.17
|
| Rate for Payer: Aetna Medicare |
$6,311.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,205.42
|
| Rate for Payer: BCBS Complete |
$5,049.49
|
| Rate for Payer: BCBS Trust/PPO |
$11,017.55
|
| Rate for Payer: BCN Commercial |
$11,017.55
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cofinity Advantage |
$8,836.61
|
| Rate for Payer: Cofinity Commercial |
$10,856.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,098.98
|
| Rate for Payer: Healthscope Commercial |
$11,361.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,836.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,467.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,098.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,730.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,467.80
|
| Rate for Payer: PHP Commercial |
$10,730.17
|
| Rate for Payer: Priority Health SBD |
$7,952.95
|
| Rate for Payer: UMR Bronson Commercial |
$4,670.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,467.80
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,623.73
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,554.44 |
| Max. Negotiated Rate |
$11,361.36 |
| Rate for Payer: Aetna American Axle |
$8,205.42
|
| Rate for Payer: Aetna Commercial |
$10,730.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,205.42
|
| Rate for Payer: Cash Price |
$10,098.98
|
| Rate for Payer: Cofinity Advantage |
$8,836.61
|
| Rate for Payer: Cofinity Commercial |
$10,856.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,098.98
|
| Rate for Payer: Healthscope Commercial |
$11,361.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,836.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,467.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,730.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,467.80
|
| Rate for Payer: PHP Commercial |
$10,730.17
|
| Rate for Payer: Priority Health SBD |
$7,952.95
|
| Rate for Payer: UMR Bronson Commercial |
$5,554.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,467.80
|
|
