|
HC IR REVSC TPVT W STENT UNILAT SF EA ADD
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37285
|
| Hospital Charge Code |
36100650
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,892.01 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,415.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UMR Bronson Commercial |
$3,892.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVSC TPVT W STEN UNILAT COMPLEX EA ADD
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37287
|
| Hospital Charge Code |
36100651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,892.01 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,415.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UMR Bronson Commercial |
$3,892.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVSC TPVT W STEN UNILAT COMPLEX EA ADD
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37287
|
| Hospital Charge Code |
36100651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,628.34 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Advantage |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,889.21
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UMR Bronson Commercial |
$4,628.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$185.90
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$81.80 |
| Max. Negotiated Rate |
$167.31 |
| Rate for Payer: Aetna American Axle |
$120.83
|
| Rate for Payer: Aetna Commercial |
$158.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.83
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cofinity Advantage |
$130.13
|
| Rate for Payer: Cofinity Commercial |
$159.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.72
|
| Rate for Payer: Healthscope Commercial |
$167.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.43
|
| Rate for Payer: PHP Commercial |
$158.01
|
| Rate for Payer: Priority Health SBD |
$117.12
|
| Rate for Payer: UMR Bronson Commercial |
$81.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.43
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$185.90
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna American Axle |
$120.83
|
| Rate for Payer: Aetna Commercial |
$158.01
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$51.96
|
| Rate for Payer: BCN Commercial |
$51.96
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cofinity Advantage |
$130.13
|
| Rate for Payer: Cofinity Commercial |
$159.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$167.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.43
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.01
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.43
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$158.01
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$117.12
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.83
|
| Rate for Payer: UHC Core |
$96.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$73.06
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$68.78
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.43
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$44.48
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.57 |
| Max. Negotiated Rate |
$40.03 |
| Rate for Payer: Aetna American Axle |
$28.91
|
| Rate for Payer: Aetna Commercial |
$37.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.91
|
| Rate for Payer: Cash Price |
$35.58
|
| Rate for Payer: Cofinity Advantage |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.58
|
| Rate for Payer: Healthscope Commercial |
$40.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.36
|
| Rate for Payer: PHP Commercial |
$37.81
|
| Rate for Payer: Priority Health SBD |
$28.02
|
| Rate for Payer: UMR Bronson Commercial |
$19.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.36
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$44.48
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.46 |
| Max. Negotiated Rate |
$40.03 |
| Rate for Payer: Aetna American Axle |
$28.91
|
| Rate for Payer: Aetna Commercial |
$37.81
|
| Rate for Payer: Aetna Medicare |
$22.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.91
|
| Rate for Payer: BCBS Complete |
$17.79
|
| Rate for Payer: Cash Price |
$35.58
|
| Rate for Payer: Cofinity Advantage |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.58
|
| Rate for Payer: Healthscope Commercial |
$40.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.36
|
| Rate for Payer: PHP Commercial |
$37.81
|
| Rate for Payer: Priority Health SBD |
$28.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.91
|
| Rate for Payer: UHC Core |
$23.17
|
| Rate for Payer: UHC Exchange |
$17.48
|
| Rate for Payer: UMR Bronson Commercial |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.36
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$368.37
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna American Axle |
$239.44
|
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$291.15
|
| Rate for Payer: BCN Commercial |
$291.15
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Advantage |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health SBD |
$232.07
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.44
|
| Rate for Payer: UHC Core |
$191.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$144.77
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$136.30
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$368.37
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.08 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna American Axle |
$239.44
|
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.44
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Advantage |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: Priority Health SBD |
$232.07
|
| Rate for Payer: UMR Bronson Commercial |
$162.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$18.43
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna American Axle |
$11.98
|
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.98
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Advantage |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health SBD |
$11.61
|
| Rate for Payer: UMR Bronson Commercial |
$8.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$18.43
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna American Axle |
$11.98
|
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna Medicare |
$9.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.98
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Advantage |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health SBD |
$11.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.98
|
| Rate for Payer: UHC Core |
$9.60
|
| Rate for Payer: UHC Exchange |
$7.24
|
| Rate for Payer: UMR Bronson Commercial |
$6.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
IP
|
$1,998.93
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$879.53 |
| Max. Negotiated Rate |
$1,799.04 |
| Rate for Payer: Aetna American Axle |
$1,299.30
|
| Rate for Payer: Aetna Commercial |
$1,699.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.30
|
| Rate for Payer: Cash Price |
$1,599.14
|
| Rate for Payer: Cofinity Advantage |
$1,399.25
|
| Rate for Payer: Cofinity Commercial |
$1,719.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.14
|
| Rate for Payer: Healthscope Commercial |
$1,799.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,399.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,699.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.20
|
| Rate for Payer: PHP Commercial |
$1,699.09
|
| Rate for Payer: Priority Health SBD |
$1,259.33
|
| Rate for Payer: UMR Bronson Commercial |
$879.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.20
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,998.93
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$123.95 |
| Max. Negotiated Rate |
$1,799.04 |
| Rate for Payer: Aetna American Axle |
$1,299.30
|
| Rate for Payer: Aetna Commercial |
$1,699.09
|
| Rate for Payer: Aetna Medicare |
$999.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.30
|
| Rate for Payer: BCBS Complete |
$799.57
|
| Rate for Payer: BCBS Trust/PPO |
$123.95
|
| Rate for Payer: BCN Commercial |
$123.95
|
| Rate for Payer: Cash Price |
$1,599.14
|
| Rate for Payer: Cash Price |
$1,599.14
|
| Rate for Payer: Cofinity Advantage |
$1,399.25
|
| Rate for Payer: Cofinity Commercial |
$1,719.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.14
|
| Rate for Payer: Healthscope Commercial |
$1,799.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,399.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,599.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,699.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.20
|
| Rate for Payer: PHP Commercial |
$1,699.09
|
| Rate for Payer: Priority Health SBD |
$1,259.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.30
|
| Rate for Payer: UHC Core |
$1,041.44
|
| Rate for Payer: UHC Exchange |
$785.58
|
| Rate for Payer: UMR Bronson Commercial |
$739.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.20
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$238.77
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.06 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna American Axle |
$155.20
|
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.20
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Advantage |
$167.14
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health SBD |
$150.43
|
| Rate for Payer: UMR Bronson Commercial |
$105.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC IR SHEATH
|
Facility
|
OP
|
$238.77
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.34 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna American Axle |
$155.20
|
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna Medicare |
$119.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.20
|
| Rate for Payer: BCBS Complete |
$95.51
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Advantage |
$167.14
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health SBD |
$150.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.20
|
| Rate for Payer: UHC Core |
$124.40
|
| Rate for Payer: UHC Exchange |
$93.84
|
| Rate for Payer: UMR Bronson Commercial |
$88.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$743.65
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$669.28 |
| Rate for Payer: Aetna American Axle |
$483.37
|
| Rate for Payer: Aetna Commercial |
$632.10
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$143.66
|
| Rate for Payer: BCN Commercial |
$143.66
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$594.92
|
| Rate for Payer: Cash Price |
$594.92
|
| Rate for Payer: Cofinity Advantage |
$520.55
|
| Rate for Payer: Cofinity Commercial |
$639.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$669.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$520.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.74
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$632.10
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$557.74
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$632.10
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$468.50
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.37
|
| Rate for Payer: UHC Core |
$387.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$292.25
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$275.15
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.74
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$743.65
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$327.21 |
| Max. Negotiated Rate |
$669.28 |
| Rate for Payer: Aetna American Axle |
$483.37
|
| Rate for Payer: Aetna Commercial |
$632.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.37
|
| Rate for Payer: Cash Price |
$594.92
|
| Rate for Payer: Cofinity Advantage |
$520.55
|
| Rate for Payer: Cofinity Commercial |
$639.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.92
|
| Rate for Payer: Healthscope Commercial |
$669.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$520.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$632.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$557.74
|
| Rate for Payer: PHP Commercial |
$632.10
|
| Rate for Payer: Priority Health SBD |
$468.50
|
| Rate for Payer: UMR Bronson Commercial |
$327.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.74
|
|
|
HC IR SIALOGRAM
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 SIALOGRAM
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$768.83 |
| Rate for Payer: Aetna American Axle |
$386.72
|
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$233.95
|
| Rate for Payer: BCN Commercial |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| 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 |
$237.74
|
| 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 |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$374.82
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.72
|
| Rate for Payer: UHC Core |
$309.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$233.82
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$220.13
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$1,492.33
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$656.63 |
| Max. Negotiated Rate |
$1,343.10 |
| Rate for Payer: Aetna American Axle |
$970.01
|
| Rate for Payer: Aetna American Axle |
$646.68
|
| Rate for Payer: Aetna Commercial |
$1,268.48
|
| Rate for Payer: Aetna Commercial |
$845.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.68
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Advantage |
$696.42
|
| Rate for Payer: Cofinity Advantage |
$1,044.63
|
| Rate for Payer: Cofinity Commercial |
$855.61
|
| Rate for Payer: Cofinity Commercial |
$1,283.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Healthscope Commercial |
$1,343.10
|
| Rate for Payer: Healthscope Commercial |
$895.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: PHP Commercial |
$1,268.48
|
| Rate for Payer: PHP Commercial |
$845.66
|
| Rate for Payer: Priority Health SBD |
$626.78
|
| Rate for Payer: Priority Health SBD |
$940.17
|
| Rate for Payer: UMR Bronson Commercial |
$656.63
|
| Rate for Payer: UMR Bronson Commercial |
$437.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.17
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$1,492.33
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$970.01
|
| Rate for Payer: Aetna American Axle |
$646.68
|
| Rate for Payer: Aetna Commercial |
$1,268.48
|
| Rate for Payer: Aetna Commercial |
$845.66
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$649.40
|
| Rate for Payer: BCBS Trust/PPO |
$649.40
|
| Rate for Payer: BCN Commercial |
$649.40
|
| Rate for Payer: BCN Commercial |
$649.40
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Advantage |
$696.42
|
| Rate for Payer: Cofinity Advantage |
$1,044.63
|
| Rate for Payer: Cofinity Commercial |
$855.61
|
| Rate for Payer: Cofinity Commercial |
$1,283.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$895.40
|
| Rate for Payer: Healthscope Commercial |
$1,343.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.25
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$845.66
|
| Rate for Payer: PHP Commercial |
$1,268.48
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| 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 Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$940.17
|
| Rate for Payer: Priority Health SBD |
$626.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$552.16
|
| Rate for Payer: UMR Bronson Commercial |
$368.11
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.17
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$1,760.71 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$566.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$87.02
|
| Rate for Payer: BCN Commercial |
$87.02
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$544.45
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$571.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$1,633.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,760.71
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,408.57
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: UMR Bronson Commercial |
$154.05
|
| Rate for Payer: VA VA |
$544.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: UMR Bronson Commercial |
$183.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,599.40
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$591.78 |
| Max. Negotiated Rate |
$2,526.13 |
| Rate for Payer: Aetna American Axle |
$1,039.61
|
| Rate for Payer: Aetna Commercial |
$1,359.49
|
| Rate for Payer: Aetna Medicare |
$799.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.61
|
| Rate for Payer: BCBS Complete |
$639.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,526.13
|
| Rate for Payer: BCN Commercial |
$2,526.13
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Advantage |
$1,119.58
|
| Rate for Payer: Cofinity Commercial |
$1,375.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Healthscope Commercial |
$1,439.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,119.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,199.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,279.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: PHP Commercial |
$1,359.49
|
| Rate for Payer: Priority Health SBD |
$1,007.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.61
|
| Rate for Payer: UHC Core |
$833.29
|
| Rate for Payer: UHC Exchange |
$628.56
|
| Rate for Payer: UMR Bronson Commercial |
$591.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,199.55
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,599.40
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$703.74 |
| Max. Negotiated Rate |
$1,439.46 |
| Rate for Payer: Aetna American Axle |
$1,039.61
|
| Rate for Payer: Aetna Commercial |
$1,359.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.61
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Advantage |
$1,119.58
|
| Rate for Payer: Cofinity Commercial |
$1,375.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Healthscope Commercial |
$1,439.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,119.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,199.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: PHP Commercial |
$1,359.49
|
| Rate for Payer: Priority Health SBD |
$1,007.62
|
| Rate for Payer: UMR Bronson Commercial |
$703.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,199.55
|
|
