|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,877.70
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$343.96 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$2,520.51
|
| Rate for Payer: Aetna Commercial |
$3,296.05
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,520.51
|
| 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 |
$343.96
|
| Rate for Payer: BCN Commercial |
$343.96
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Advantage |
$2,714.39
|
| Rate for Payer: Cofinity Commercial |
$3,334.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$3,489.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,714.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.28
|
| 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 |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$3,296.05
|
| 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 |
$2,442.95
|
| 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) |
$2,520.51
|
| Rate for Payer: UHC Core |
$2,020.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$1,523.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,434.75
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.28
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,877.70
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,706.19 |
| Max. Negotiated Rate |
$3,489.93 |
| Rate for Payer: Aetna American Axle |
$2,520.51
|
| Rate for Payer: Aetna Commercial |
$3,296.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,520.51
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Advantage |
$2,714.39
|
| Rate for Payer: Cofinity Commercial |
$3,334.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Healthscope Commercial |
$3,489.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,714.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: PHP Commercial |
$3,296.05
|
| Rate for Payer: Priority Health SBD |
$2,442.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,706.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.28
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,707.29
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,191.21 |
| Max. Negotiated Rate |
$2,436.56 |
| Rate for Payer: Aetna American Axle |
$1,759.74
|
| Rate for Payer: Aetna Commercial |
$2,301.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,759.74
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cofinity Advantage |
$1,895.10
|
| Rate for Payer: Cofinity Commercial |
$2,328.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,165.83
|
| Rate for Payer: Healthscope Commercial |
$2,436.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,895.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,030.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,301.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.47
|
| Rate for Payer: PHP Commercial |
$2,301.20
|
| Rate for Payer: Priority Health SBD |
$1,705.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,191.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,030.47
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,707.29
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.25 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna American Axle |
$1,759.74
|
| Rate for Payer: Aetna Commercial |
$2,301.20
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,759.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$159.25
|
| Rate for Payer: BCN Commercial |
$159.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cofinity Advantage |
$1,895.10
|
| Rate for Payer: Cofinity Commercial |
$2,328.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,165.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$2,436.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,895.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,030.47
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,301.20
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.47
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$2,301.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,705.59
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.74
|
| Rate for Payer: UHC Core |
$1,410.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$1,063.96
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,001.70
|
| Rate for Payer: VA VA |
$1,568.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,030.47
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$8,632.22
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,193.92 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$5,610.94
|
| Rate for Payer: Aetna Commercial |
$7,337.39
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,610.94
|
| 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 |
$5,549.15
|
| Rate for Payer: BCN Commercial |
$5,549.15
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cofinity Advantage |
$6,042.55
|
| Rate for Payer: Cofinity Commercial |
$7,423.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,905.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$7,769.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,042.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,474.16
|
| 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 |
$7,337.39
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,474.16
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$7,337.39
|
| 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 |
$5,438.30
|
| 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 |
$3,193.92
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,474.16
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$8,632.22
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,798.18 |
| Max. Negotiated Rate |
$7,769.00 |
| Rate for Payer: Aetna American Axle |
$5,610.94
|
| Rate for Payer: Aetna Commercial |
$7,337.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,610.94
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cofinity Advantage |
$6,042.55
|
| Rate for Payer: Cofinity Commercial |
$7,423.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,905.78
|
| Rate for Payer: Healthscope Commercial |
$7,769.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,042.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,474.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,337.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,474.16
|
| Rate for Payer: PHP Commercial |
$7,337.39
|
| Rate for Payer: Priority Health SBD |
$5,438.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,798.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,474.16
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,451.87
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,078.82 |
| Max. Negotiated Rate |
$2,206.68 |
| Rate for Payer: Aetna American Axle |
$1,593.72
|
| Rate for Payer: Aetna Commercial |
$2,084.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,593.72
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cofinity Advantage |
$1,716.31
|
| Rate for Payer: Cofinity Commercial |
$2,108.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,961.50
|
| Rate for Payer: Healthscope Commercial |
$2,206.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,716.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,838.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.90
|
| Rate for Payer: PHP Commercial |
$2,084.09
|
| Rate for Payer: Priority Health SBD |
$1,544.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,078.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,838.90
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,451.87
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.19 |
| Max. Negotiated Rate |
$5,780.47 |
| Rate for Payer: Aetna American Axle |
$1,593.72
|
| Rate for Payer: Aetna Commercial |
$2,084.09
|
| Rate for Payer: Aetna Medicare |
$1,225.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,593.72
|
| Rate for Payer: BCBS Complete |
$980.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,780.47
|
| Rate for Payer: BCN Commercial |
$5,780.47
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cofinity Advantage |
$1,716.31
|
| Rate for Payer: Cofinity Commercial |
$2,108.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,961.50
|
| Rate for Payer: Healthscope Commercial |
$2,206.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,716.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,838.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,961.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.90
|
| Rate for Payer: PHP Commercial |
$2,084.09
|
| Rate for Payer: Priority Health SBD |
$1,544.68
|
| Rate for Payer: UMR Bronson Commercial |
$907.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,838.90
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,832.40
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,566.26 |
| Max. Negotiated Rate |
$5,249.16 |
| Rate for Payer: Aetna American Axle |
$3,791.06
|
| Rate for Payer: Aetna Commercial |
$4,957.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,791.06
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cofinity Advantage |
$4,082.68
|
| Rate for Payer: Cofinity Commercial |
$5,015.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,665.92
|
| Rate for Payer: Healthscope Commercial |
$5,249.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,082.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,374.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,957.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,374.30
|
| Rate for Payer: PHP Commercial |
$4,957.54
|
| Rate for Payer: Priority Health SBD |
$3,674.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,566.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,374.30
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,832.40
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,157.99 |
| Max. Negotiated Rate |
$5,249.16 |
| Rate for Payer: Aetna American Axle |
$3,791.06
|
| Rate for Payer: Aetna Commercial |
$4,957.54
|
| Rate for Payer: Aetna Medicare |
$2,916.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,791.06
|
| Rate for Payer: BCBS Complete |
$2,332.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,052.80
|
| Rate for Payer: BCN Commercial |
$3,052.80
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cofinity Advantage |
$4,082.68
|
| Rate for Payer: Cofinity Commercial |
$5,015.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,665.92
|
| Rate for Payer: Healthscope Commercial |
$5,249.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,082.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,374.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,665.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,957.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,374.30
|
| Rate for Payer: PHP Commercial |
$4,957.54
|
| Rate for Payer: Priority Health SBD |
$3,674.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,157.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,374.30
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,814.36
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,438.32 |
| Max. Negotiated Rate |
$7,032.92 |
| Rate for Payer: Aetna American Axle |
$5,079.33
|
| Rate for Payer: Aetna Commercial |
$6,642.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,079.33
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cofinity Advantage |
$5,470.05
|
| Rate for Payer: Cofinity Commercial |
$6,720.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,251.49
|
| Rate for Payer: Healthscope Commercial |
$7,032.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,470.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,860.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,642.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,860.77
|
| Rate for Payer: PHP Commercial |
$6,642.21
|
| Rate for Payer: Priority Health SBD |
$4,923.05
|
| Rate for Payer: UMR Bronson Commercial |
$3,438.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,860.77
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,814.36
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,891.31 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$5,079.33
|
| Rate for Payer: Aetna Commercial |
$6,642.21
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,079.33
|
| 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: BCBS Trust/PPO |
$4,655.24
|
| Rate for Payer: BCN Commercial |
$4,655.24
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cofinity Advantage |
$5,470.05
|
| Rate for Payer: Cofinity Commercial |
$6,720.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,251.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$7,032.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,470.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,860.77
|
| 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 |
$6,642.21
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,860.77
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$6,642.21
|
| 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 |
$4,923.05
|
| 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 |
$2,891.31
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,860.77
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,476.98
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$3,560.04
|
| Rate for Payer: Aetna Commercial |
$4,655.43
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,560.04
|
| 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 |
$3,367.66
|
| Rate for Payer: BCN Commercial |
$3,367.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cofinity Advantage |
$3,833.89
|
| Rate for Payer: Cofinity Commercial |
$4,710.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,381.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,929.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,833.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,107.73
|
| 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 |
$4,655.43
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,107.73
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,655.43
|
| 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 |
$3,450.50
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,026.48
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,107.73
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,476.98
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,409.87 |
| Max. Negotiated Rate |
$4,929.28 |
| Rate for Payer: Aetna American Axle |
$3,560.04
|
| Rate for Payer: Aetna Commercial |
$4,655.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,560.04
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cofinity Advantage |
$3,833.89
|
| Rate for Payer: Cofinity Commercial |
$4,710.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,381.58
|
| Rate for Payer: Healthscope Commercial |
$4,929.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,833.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,107.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,655.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,107.73
|
| Rate for Payer: PHP Commercial |
$4,655.43
|
| Rate for Payer: Priority Health SBD |
$3,450.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,409.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,107.73
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,834.43
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$807.15 |
| Max. Negotiated Rate |
$1,650.99 |
| Rate for Payer: Aetna American Axle |
$1,192.38
|
| Rate for Payer: Aetna Commercial |
$1,559.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.38
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cofinity Advantage |
$1,284.10
|
| Rate for Payer: Cofinity Commercial |
$1,577.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.54
|
| Rate for Payer: Healthscope Commercial |
$1,650.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,284.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,375.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,375.82
|
| Rate for Payer: PHP Commercial |
$1,559.27
|
| Rate for Payer: Priority Health SBD |
$1,155.69
|
| Rate for Payer: UMR Bronson Commercial |
$807.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,375.82
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,834.43
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$678.74 |
| Max. Negotiated Rate |
$1,650.99 |
| Rate for Payer: Aetna American Axle |
$1,192.38
|
| Rate for Payer: Aetna Commercial |
$1,559.27
|
| Rate for Payer: Aetna Medicare |
$917.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.38
|
| Rate for Payer: BCBS Complete |
$733.77
|
| Rate for Payer: BCBS Trust/PPO |
$963.73
|
| Rate for Payer: BCN Commercial |
$963.73
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cofinity Advantage |
$1,284.10
|
| Rate for Payer: Cofinity Commercial |
$1,577.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.54
|
| Rate for Payer: Healthscope Commercial |
$1,650.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,284.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,375.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,467.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,375.82
|
| Rate for Payer: PHP Commercial |
$1,559.27
|
| Rate for Payer: Priority Health SBD |
$1,155.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,192.38
|
| Rate for Payer: UHC Core |
$955.74
|
| Rate for Payer: UHC Exchange |
$720.93
|
| Rate for Payer: UMR Bronson Commercial |
$678.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,375.82
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,215.93
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$975.01 |
| Max. Negotiated Rate |
$1,994.34 |
| Rate for Payer: Aetna American Axle |
$1,440.35
|
| Rate for Payer: Aetna Commercial |
$1,883.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.35
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cofinity Advantage |
$1,551.15
|
| Rate for Payer: Cofinity Commercial |
$1,905.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,772.74
|
| Rate for Payer: Healthscope Commercial |
$1,994.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,551.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,661.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,883.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.95
|
| Rate for Payer: PHP Commercial |
$1,883.54
|
| Rate for Payer: Priority Health SBD |
$1,396.04
|
| Rate for Payer: UMR Bronson Commercial |
$975.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,661.95
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,215.93
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$1,994.34 |
| Rate for Payer: Aetna American Axle |
$1,440.35
|
| Rate for Payer: Aetna Commercial |
$1,883.54
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.35
|
| 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 |
$243.78
|
| Rate for Payer: BCN Commercial |
$243.78
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cofinity Advantage |
$1,551.15
|
| Rate for Payer: Cofinity Commercial |
$1,905.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,772.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$1,994.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,551.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,661.95
|
| 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 |
$1,883.54
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.95
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$1,883.54
|
| 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 |
$1,396.04
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$819.89
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,661.95
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$472.70
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.99 |
| Max. Negotiated Rate |
$425.43 |
| Rate for Payer: Aetna American Axle |
$307.25
|
| Rate for Payer: Aetna Commercial |
$401.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.25
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cofinity Advantage |
$330.89
|
| Rate for Payer: Cofinity Commercial |
$406.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.16
|
| Rate for Payer: Healthscope Commercial |
$425.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.52
|
| Rate for Payer: PHP Commercial |
$401.80
|
| Rate for Payer: Priority Health SBD |
$297.80
|
| Rate for Payer: UMR Bronson Commercial |
$207.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.52
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$472.70
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.90 |
| Max. Negotiated Rate |
$1,124.16 |
| Rate for Payer: Aetna American Axle |
$307.25
|
| Rate for Payer: Aetna Commercial |
$401.80
|
| Rate for Payer: Aetna Medicare |
$361.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$269.25
|
| Rate for Payer: BCN Commercial |
$269.25
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cofinity Advantage |
$330.89
|
| Rate for Payer: Cofinity Commercial |
$406.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$425.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.52
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$365.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.80
|
| Rate for Payer: Nomi Health Commercial |
$1,042.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.52
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$401.80
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,124.16
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health SBD |
$297.80
|
| Rate for Payer: Priority Health Tiered Network |
$899.33
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.25
|
| Rate for Payer: UHC Core |
$246.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$185.77
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: UMR Bronson Commercial |
$174.90
|
| Rate for Payer: VA VA |
$347.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.52
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$61.57 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$182.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: BCBS Complete |
$145.81
|
| Rate for Payer: BCBS Trust/PPO |
$61.57
|
| Rate for Payer: BCN Commercial |
$61.57
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UMR Bronson Commercial |
$134.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$160.39 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: UMR Bronson Commercial |
$160.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$500.21
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.08 |
| Max. Negotiated Rate |
$747.58 |
| Rate for Payer: Aetna American Axle |
$325.14
|
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: Aetna Medicare |
$250.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.14
|
| Rate for Payer: BCBS Complete |
$200.08
|
| Rate for Payer: BCBS Trust/PPO |
$747.58
|
| Rate for Payer: BCN Commercial |
$747.58
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Advantage |
$350.15
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: Priority Health SBD |
$315.13
|
| Rate for Payer: UMR Bronson Commercial |
$185.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$500.21
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.09 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna American Axle |
$325.14
|
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.14
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Advantage |
$350.15
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: Priority Health SBD |
$315.13
|
| Rate for Payer: UMR Bronson Commercial |
$220.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,145.14
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$503.86 |
| Max. Negotiated Rate |
$1,030.63 |
| Rate for Payer: Aetna American Axle |
$744.34
|
| Rate for Payer: Aetna Commercial |
$973.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.34
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Advantage |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$984.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Healthscope Commercial |
$1,030.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$801.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: PHP Commercial |
$973.37
|
| Rate for Payer: Priority Health SBD |
$721.44
|
| Rate for Payer: UMR Bronson Commercial |
$503.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.86
|
|
