|
HC SP REPOSITION IVC FILTER
|
Facility
|
OP
|
$4,195.50
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.08 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,727.08
|
| Rate for Payer: Aetna Commercial |
$3,566.18
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,727.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,356.40
|
| Rate for Payer: Cash Price |
$3,356.40
|
| Rate for Payer: Cofinity Commercial |
$3,608.13
|
| Rate for Payer: Cofinity Commercial |
$2,936.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,356.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,775.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,936.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,146.62
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,566.18
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,566.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,936.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,643.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.99
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$329.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,552.34
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,146.62
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
OP
|
$682.65
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$443.72
|
| Rate for Payer: Aetna Commercial |
$580.25
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$136.36
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$546.12
|
| Rate for Payer: Cash Price |
$546.12
|
| Rate for Payer: Cofinity Commercial |
$477.86
|
| Rate for Payer: Cofinity Commercial |
$587.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$614.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$477.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$511.99
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.25
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$580.25
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$430.07
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$252.58
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$511.99
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
IP
|
$682.65
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.37 |
| Max. Negotiated Rate |
$614.38 |
| Rate for Payer: Aetna American Axle |
$443.72
|
| Rate for Payer: Aetna Commercial |
$580.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.72
|
| Rate for Payer: Cash Price |
$546.12
|
| Rate for Payer: Cofinity Commercial |
$477.86
|
| Rate for Payer: Cofinity Commercial |
$587.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.12
|
| Rate for Payer: Healthscope Commercial |
$614.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$477.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$511.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.25
|
| Rate for Payer: PHP Commercial |
$580.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.86
|
| Rate for Payer: Priority Health SBD |
$430.07
|
| Rate for Payer: UMR Bronson Commercial |
$300.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$511.99
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
OP
|
$1,053.73
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$50.10 |
| Max. Negotiated Rate |
$948.36 |
| Rate for Payer: Aetna American Axle |
$684.92
|
| Rate for Payer: Aetna Commercial |
$895.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.92
|
| Rate for Payer: BCBS Complete |
$421.49
|
| Rate for Payer: BCBS Trust/PPO |
$567.37
|
| Rate for Payer: Cash Price |
$842.98
|
| Rate for Payer: Cash Price |
$842.98
|
| Rate for Payer: Cofinity Commercial |
$737.61
|
| Rate for Payer: Cofinity Commercial |
$906.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.98
|
| Rate for Payer: Healthscope Commercial |
$948.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$895.67
|
| Rate for Payer: PHP Commercial |
$895.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.61
|
| Rate for Payer: Priority Health SBD |
$663.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.11
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$50.10
|
| Rate for Payer: UMR Bronson Commercial |
$389.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.30
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
IP
|
$1,053.73
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.64 |
| Max. Negotiated Rate |
$948.36 |
| Rate for Payer: Aetna American Axle |
$684.92
|
| Rate for Payer: Aetna Commercial |
$895.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.92
|
| Rate for Payer: Cash Price |
$842.98
|
| Rate for Payer: Cofinity Commercial |
$737.61
|
| Rate for Payer: Cofinity Commercial |
$906.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.98
|
| Rate for Payer: Healthscope Commercial |
$948.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$895.67
|
| Rate for Payer: PHP Commercial |
$895.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.61
|
| Rate for Payer: Priority Health SBD |
$663.85
|
| Rate for Payer: UMR Bronson Commercial |
$463.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.30
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
IP
|
$6,140.07
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,701.63 |
| Max. Negotiated Rate |
$5,526.06 |
| Rate for Payer: Aetna American Axle |
$3,991.05
|
| Rate for Payer: Aetna Commercial |
$5,219.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.05
|
| Rate for Payer: Cash Price |
$4,912.06
|
| Rate for Payer: Cofinity Commercial |
$4,298.05
|
| Rate for Payer: Cofinity Commercial |
$5,280.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,912.06
|
| Rate for Payer: Healthscope Commercial |
$5,526.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,298.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,605.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,219.06
|
| Rate for Payer: PHP Commercial |
$5,219.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,298.05
|
| Rate for Payer: Priority Health SBD |
$3,868.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,701.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,605.05
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
OP
|
$6,140.07
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,271.83 |
| Max. Negotiated Rate |
$5,526.06 |
| Rate for Payer: Aetna American Axle |
$3,991.05
|
| Rate for Payer: Aetna Commercial |
$5,219.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.05
|
| Rate for Payer: BCBS Complete |
$2,456.03
|
| Rate for Payer: Cash Price |
$4,912.06
|
| Rate for Payer: Cofinity Commercial |
$4,298.05
|
| Rate for Payer: Cofinity Commercial |
$5,280.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,912.06
|
| Rate for Payer: Healthscope Commercial |
$5,526.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,298.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,605.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,219.06
|
| Rate for Payer: PHP Commercial |
$5,219.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,298.05
|
| Rate for Payer: Priority Health SBD |
$3,868.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,271.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,605.05
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
IP
|
$2,396.89
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,054.63 |
| Max. Negotiated Rate |
$2,157.20 |
| Rate for Payer: Aetna American Axle |
$1,557.98
|
| Rate for Payer: Aetna Commercial |
$2,037.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,557.98
|
| Rate for Payer: Cash Price |
$1,917.51
|
| Rate for Payer: Cofinity Commercial |
$1,677.82
|
| Rate for Payer: Cofinity Commercial |
$2,061.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.51
|
| Rate for Payer: Healthscope Commercial |
$2,157.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,677.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,037.36
|
| Rate for Payer: PHP Commercial |
$2,037.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.82
|
| Rate for Payer: Priority Health SBD |
$1,510.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,054.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.67
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
OP
|
$2,396.89
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.85 |
| Max. Negotiated Rate |
$2,157.20 |
| Rate for Payer: Aetna American Axle |
$1,557.98
|
| Rate for Payer: Aetna Commercial |
$2,037.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,557.98
|
| Rate for Payer: BCBS Complete |
$958.76
|
| Rate for Payer: Cash Price |
$1,917.51
|
| Rate for Payer: Cofinity Commercial |
$1,677.82
|
| Rate for Payer: Cofinity Commercial |
$2,061.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.51
|
| Rate for Payer: Healthscope Commercial |
$2,157.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,677.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,037.36
|
| Rate for Payer: PHP Commercial |
$2,037.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.82
|
| Rate for Payer: Priority Health SBD |
$1,510.04
|
| Rate for Payer: UMR Bronson Commercial |
$886.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.67
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,660.56 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna American Axle |
$2,453.10
|
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,641.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,660.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
OP
|
$3,774.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$398.17 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,453.10
|
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,641.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.99
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$398.17
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.38
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,660.56 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna American Axle |
$2,453.10
|
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,641.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,660.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
OP
|
$3,774.00
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.94 |
| Max. Negotiated Rate |
$15,377.24 |
| Rate for Payer: Aetna American Axle |
$2,453.10
|
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna Medicare |
$5,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,622.94
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,641.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,377.24
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$12,301.79
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.63
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,884.69
|
| Rate for Payer: UHC Exchange |
$336.94
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.38
|
| Rate for Payer: VA VA |
$4,884.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
IP
|
$406.40
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.82 |
| Max. Negotiated Rate |
$365.76 |
| Rate for Payer: Aetna American Axle |
$264.16
|
| Rate for Payer: Aetna Commercial |
$345.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.16
|
| Rate for Payer: Cash Price |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$284.48
|
| Rate for Payer: Cofinity Commercial |
$349.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.12
|
| Rate for Payer: Healthscope Commercial |
$365.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.44
|
| Rate for Payer: PHP Commercial |
$345.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.48
|
| Rate for Payer: Priority Health SBD |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$178.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.80
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
OP
|
$406.40
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.37 |
| Max. Negotiated Rate |
$365.76 |
| Rate for Payer: Aetna American Axle |
$264.16
|
| Rate for Payer: Aetna Commercial |
$345.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.16
|
| Rate for Payer: BCBS Complete |
$162.56
|
| Rate for Payer: Cash Price |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$284.48
|
| Rate for Payer: Cofinity Commercial |
$349.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.12
|
| Rate for Payer: Healthscope Commercial |
$365.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.44
|
| Rate for Payer: PHP Commercial |
$345.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.48
|
| Rate for Payer: Priority Health SBD |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$150.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.80
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
OP
|
$1,004.03
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$371.49 |
| Max. Negotiated Rate |
$903.63 |
| Rate for Payer: Aetna American Axle |
$652.62
|
| Rate for Payer: Aetna Commercial |
$853.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.62
|
| Rate for Payer: BCBS Complete |
$401.61
|
| Rate for Payer: Cash Price |
$803.22
|
| Rate for Payer: Cofinity Commercial |
$702.82
|
| Rate for Payer: Cofinity Commercial |
$863.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$803.22
|
| Rate for Payer: Healthscope Commercial |
$903.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$702.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$753.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$853.43
|
| Rate for Payer: PHP Commercial |
$853.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$702.82
|
| Rate for Payer: Priority Health SBD |
$632.54
|
| Rate for Payer: UMR Bronson Commercial |
$371.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$753.02
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
IP
|
$1,004.03
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.77 |
| Max. Negotiated Rate |
$903.63 |
| Rate for Payer: Aetna American Axle |
$652.62
|
| Rate for Payer: Aetna Commercial |
$853.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.62
|
| Rate for Payer: Cash Price |
$803.22
|
| Rate for Payer: Cofinity Commercial |
$702.82
|
| Rate for Payer: Cofinity Commercial |
$863.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$803.22
|
| Rate for Payer: Healthscope Commercial |
$903.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$702.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$753.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$853.43
|
| Rate for Payer: PHP Commercial |
$853.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$702.82
|
| Rate for Payer: Priority Health SBD |
$632.54
|
| Rate for Payer: UMR Bronson Commercial |
$441.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$753.02
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
IP
|
$1,252.58
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$551.14 |
| Max. Negotiated Rate |
$1,127.32 |
| Rate for Payer: Aetna American Axle |
$814.18
|
| Rate for Payer: Aetna Commercial |
$1,064.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.18
|
| Rate for Payer: Cash Price |
$1,002.06
|
| Rate for Payer: Cofinity Commercial |
$1,077.22
|
| Rate for Payer: Cofinity Commercial |
$876.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.06
|
| Rate for Payer: Healthscope Commercial |
$1,127.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$876.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$939.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,064.69
|
| Rate for Payer: PHP Commercial |
$1,064.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.81
|
| Rate for Payer: Priority Health SBD |
$789.13
|
| Rate for Payer: UMR Bronson Commercial |
$551.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$939.44
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
OP
|
$1,252.58
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.39 |
| Max. Negotiated Rate |
$2,941.80 |
| Rate for Payer: Aetna American Axle |
$814.18
|
| Rate for Payer: Aetna Commercial |
$1,064.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.18
|
| Rate for Payer: BCBS Complete |
$501.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,941.80
|
| Rate for Payer: Cash Price |
$1,002.06
|
| Rate for Payer: Cash Price |
$1,002.06
|
| Rate for Payer: Cofinity Commercial |
$1,077.22
|
| Rate for Payer: Cofinity Commercial |
$876.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.06
|
| Rate for Payer: Healthscope Commercial |
$1,127.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$876.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$939.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,064.69
|
| Rate for Payer: PHP Commercial |
$1,064.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.81
|
| Rate for Payer: Priority Health SBD |
$789.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.73
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$163.39
|
| Rate for Payer: UMR Bronson Commercial |
$463.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$939.44
|
|
|
HC SP Z TRUE FILL
|
Facility
|
OP
|
$6,624.52
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,451.07 |
| Max. Negotiated Rate |
$5,962.07 |
| Rate for Payer: Aetna American Axle |
$4,305.94
|
| Rate for Payer: Aetna Commercial |
$5,630.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.94
|
| Rate for Payer: BCBS Complete |
$2,649.81
|
| Rate for Payer: Cash Price |
$5,299.62
|
| Rate for Payer: Cofinity Commercial |
$4,637.16
|
| Rate for Payer: Cofinity Commercial |
$5,697.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.62
|
| Rate for Payer: Healthscope Commercial |
$5,962.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,637.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,968.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,630.84
|
| Rate for Payer: PHP Commercial |
$5,630.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,637.16
|
| Rate for Payer: Priority Health SBD |
$4,173.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,451.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,968.39
|
|
|
HC SP Z TRUE FILL
|
Facility
|
IP
|
$6,624.52
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,914.79 |
| Max. Negotiated Rate |
$5,962.07 |
| Rate for Payer: Aetna American Axle |
$4,305.94
|
| Rate for Payer: Aetna Commercial |
$5,630.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,305.94
|
| Rate for Payer: Cash Price |
$5,299.62
|
| Rate for Payer: Cofinity Commercial |
$4,637.16
|
| Rate for Payer: Cofinity Commercial |
$5,697.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.62
|
| Rate for Payer: Healthscope Commercial |
$5,962.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,637.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,968.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,630.84
|
| Rate for Payer: PHP Commercial |
$5,630.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,637.16
|
| Rate for Payer: Priority Health SBD |
$4,173.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,914.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,968.39
|
|
|
HC SQ ICD
|
Facility
|
OP
|
$55,312.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20,465.44 |
| Max. Negotiated Rate |
$49,780.80 |
| Rate for Payer: Aetna American Axle |
$35,952.80
|
| Rate for Payer: Aetna Commercial |
$47,015.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35,952.80
|
| Rate for Payer: BCBS Complete |
$22,124.80
|
| Rate for Payer: Cash Price |
$44,249.60
|
| Rate for Payer: Cofinity Commercial |
$38,718.40
|
| Rate for Payer: Cofinity Commercial |
$47,568.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44,249.60
|
| Rate for Payer: Healthscope Commercial |
$49,780.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38,718.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41,484.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47,015.20
|
| Rate for Payer: PHP Commercial |
$47,015.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38,718.40
|
| Rate for Payer: Priority Health SBD |
$34,846.56
|
| Rate for Payer: UMR Bronson Commercial |
$20,465.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41,484.00
|
|
|
HC SQ ICD
|
Facility
|
IP
|
$55,312.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24,337.28 |
| Max. Negotiated Rate |
$49,780.80 |
| Rate for Payer: Aetna American Axle |
$35,952.80
|
| Rate for Payer: Aetna Commercial |
$47,015.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35,952.80
|
| Rate for Payer: Cash Price |
$44,249.60
|
| Rate for Payer: Cofinity Commercial |
$38,718.40
|
| Rate for Payer: Cofinity Commercial |
$47,568.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44,249.60
|
| Rate for Payer: Healthscope Commercial |
$49,780.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38,718.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41,484.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47,015.20
|
| Rate for Payer: PHP Commercial |
$47,015.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38,718.40
|
| Rate for Payer: Priority Health SBD |
$34,846.56
|
| Rate for Payer: UMR Bronson Commercial |
$24,337.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41,484.00
|
|
|
HC SQ ICD LEAD
|
Facility
|
IP
|
$14,375.00
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,325.00 |
| Max. Negotiated Rate |
$12,937.50 |
| Rate for Payer: Aetna American Axle |
$9,343.75
|
| Rate for Payer: Aetna Commercial |
$12,218.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,343.75
|
| Rate for Payer: Cash Price |
$11,500.00
|
| Rate for Payer: Cofinity Commercial |
$10,062.50
|
| Rate for Payer: Cofinity Commercial |
$12,362.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,500.00
|
| Rate for Payer: Healthscope Commercial |
$12,937.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,062.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,781.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,218.75
|
| Rate for Payer: PHP Commercial |
$12,218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,062.50
|
| Rate for Payer: Priority Health SBD |
$9,056.25
|
| Rate for Payer: UMR Bronson Commercial |
$6,325.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,781.25
|
|
|
HC SQ ICD LEAD
|
Facility
|
OP
|
$14,375.00
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,318.75 |
| Max. Negotiated Rate |
$12,937.50 |
| Rate for Payer: Aetna American Axle |
$9,343.75
|
| Rate for Payer: Aetna Commercial |
$12,218.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,343.75
|
| Rate for Payer: BCBS Complete |
$5,750.00
|
| Rate for Payer: Cash Price |
$11,500.00
|
| Rate for Payer: Cofinity Commercial |
$10,062.50
|
| Rate for Payer: Cofinity Commercial |
$12,362.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,500.00
|
| Rate for Payer: Healthscope Commercial |
$12,937.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,062.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,781.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,218.75
|
| Rate for Payer: PHP Commercial |
$12,218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,062.50
|
| Rate for Payer: Priority Health SBD |
$9,056.25
|
| Rate for Payer: UMR Bronson Commercial |
$5,318.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,781.25
|
|
