|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
OP
|
$12,605.08
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$11,344.57 |
| Rate for Payer: Aetna American Axle |
$8,193.30
|
| Rate for Payer: Aetna Commercial |
$10,714.32
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,193.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,829.36
|
| Rate for Payer: BCN Commercial |
$3,829.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$10,084.06
|
| Rate for Payer: Cash Price |
$10,084.06
|
| Rate for Payer: Cofinity Advantage |
$8,823.56
|
| Rate for Payer: Cofinity Commercial |
$10,840.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,084.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$11,344.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,823.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,453.81
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,714.32
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,453.81
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$10,714.32
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$7,941.20
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$4,663.88
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,453.81
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
IP
|
$12,605.08
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,546.24 |
| Max. Negotiated Rate |
$11,344.57 |
| Rate for Payer: Aetna American Axle |
$8,193.30
|
| Rate for Payer: Aetna Commercial |
$10,714.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,193.30
|
| Rate for Payer: Cash Price |
$10,084.06
|
| Rate for Payer: Cofinity Advantage |
$8,823.56
|
| Rate for Payer: Cofinity Commercial |
$10,840.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,084.06
|
| Rate for Payer: Healthscope Commercial |
$11,344.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,823.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,453.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,714.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,453.81
|
| Rate for Payer: PHP Commercial |
$10,714.32
|
| Rate for Payer: Priority Health SBD |
$7,941.20
|
| Rate for Payer: UMR Bronson Commercial |
$5,546.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,453.81
|
|
|
HC LUMASON PER ML
|
Facility
|
IP
|
$81.09
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.68 |
| Max. Negotiated Rate |
$72.98 |
| Rate for Payer: Aetna American Axle |
$52.71
|
| Rate for Payer: Aetna Commercial |
$68.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.71
|
| Rate for Payer: Cash Price |
$64.87
|
| Rate for Payer: Cofinity Advantage |
$56.76
|
| Rate for Payer: Cofinity Commercial |
$69.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.87
|
| Rate for Payer: Healthscope Commercial |
$72.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.82
|
| Rate for Payer: PHP Commercial |
$68.93
|
| Rate for Payer: Priority Health SBD |
$51.09
|
| Rate for Payer: UMR Bronson Commercial |
$35.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.82
|
|
|
HC LUMASON PER ML
|
Facility
|
OP
|
$81.09
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.19 |
| Max. Negotiated Rate |
$72.98 |
| Rate for Payer: Aetna American Axle |
$52.71
|
| Rate for Payer: Aetna Commercial |
$68.93
|
| Rate for Payer: Aetna Medicare |
$40.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.71
|
| Rate for Payer: BCBS Complete |
$32.44
|
| Rate for Payer: BCBS Trust/PPO |
$29.19
|
| Rate for Payer: BCN Commercial |
$29.19
|
| Rate for Payer: Cash Price |
$64.87
|
| Rate for Payer: Cash Price |
$64.87
|
| Rate for Payer: Cofinity Advantage |
$56.76
|
| Rate for Payer: Cofinity Commercial |
$69.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.87
|
| Rate for Payer: Healthscope Commercial |
$72.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.82
|
| Rate for Payer: PHP Commercial |
$68.93
|
| Rate for Payer: Priority Health SBD |
$51.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.98
|
| Rate for Payer: UHC Core |
$29.98
|
| Rate for Payer: UHC Exchange |
$29.98
|
| Rate for Payer: UMR Bronson Commercial |
$30.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.82
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
IP
|
$763.51
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$335.94 |
| Max. Negotiated Rate |
$687.16 |
| Rate for Payer: Aetna American Axle |
$496.28
|
| Rate for Payer: Aetna Commercial |
$648.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.28
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cofinity Advantage |
$534.46
|
| Rate for Payer: Cofinity Commercial |
$656.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.81
|
| Rate for Payer: Healthscope Commercial |
$687.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$534.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$572.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.63
|
| Rate for Payer: PHP Commercial |
$648.98
|
| Rate for Payer: Priority Health SBD |
$481.01
|
| Rate for Payer: UMR Bronson Commercial |
$335.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$572.63
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
OP
|
$763.51
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$687.16 |
| Rate for Payer: Aetna American Axle |
$496.28
|
| Rate for Payer: Aetna Commercial |
$648.98
|
| Rate for Payer: Aetna Medicare |
$381.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.28
|
| Rate for Payer: BCBS Complete |
$305.40
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cofinity Advantage |
$534.46
|
| Rate for Payer: Cofinity Commercial |
$656.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.81
|
| Rate for Payer: Healthscope Commercial |
$687.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$534.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$572.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.63
|
| Rate for Payer: PHP Commercial |
$648.98
|
| Rate for Payer: Priority Health SBD |
$481.01
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$282.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$572.63
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$934.71
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$345.84 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$607.56
|
| Rate for Payer: Aetna Commercial |
$794.50
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.31
|
| Rate for Payer: BCN Commercial |
$1,149.31
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cofinity Advantage |
$654.30
|
| Rate for Payer: Cofinity Commercial |
$803.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$841.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$654.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$701.03
|
| Rate for Payer: Mclaren Medicaid |
$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 Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.50
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.03
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$794.50
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| 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 Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$588.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.56
|
| Rate for Payer: UHC Core |
$486.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$367.34
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$345.84
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$701.03
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$934.71
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$411.27 |
| Max. Negotiated Rate |
$841.24 |
| Rate for Payer: Aetna American Axle |
$607.56
|
| Rate for Payer: Aetna Commercial |
$794.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.56
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cofinity Advantage |
$654.30
|
| Rate for Payer: Cofinity Commercial |
$803.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.77
|
| Rate for Payer: Healthscope Commercial |
$841.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$654.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$701.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.03
|
| Rate for Payer: PHP Commercial |
$794.50
|
| Rate for Payer: Priority Health SBD |
$588.87
|
| Rate for Payer: UMR Bronson Commercial |
$411.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$701.03
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$786.42
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$346.02 |
| Max. Negotiated Rate |
$707.78 |
| Rate for Payer: Aetna American Axle |
$511.17
|
| Rate for Payer: Aetna Commercial |
$668.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.17
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cofinity Advantage |
$550.49
|
| Rate for Payer: Cofinity Commercial |
$676.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.14
|
| Rate for Payer: Healthscope Commercial |
$707.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$589.82
|
| Rate for Payer: PHP Commercial |
$668.46
|
| Rate for Payer: Priority Health SBD |
$495.44
|
| Rate for Payer: UMR Bronson Commercial |
$346.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.82
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$786.42
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$290.98 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$511.17
|
| Rate for Payer: Aetna Commercial |
$668.46
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$515.73
|
| Rate for Payer: BCN Commercial |
$515.73
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cofinity Advantage |
$550.49
|
| Rate for Payer: Cofinity Commercial |
$676.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$707.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.82
|
| Rate for Payer: Mclaren Medicaid |
$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 Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.46
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$589.82
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$668.46
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| 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 Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$495.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$511.17
|
| Rate for Payer: UHC Core |
$409.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$309.06
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$290.98
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.82
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
OP
|
$2,150.09
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$795.53 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,397.56
|
| Rate for Payer: Aetna Commercial |
$1,827.58
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,219.42
|
| Rate for Payer: BCN Commercial |
$1,219.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cofinity Advantage |
$1,505.06
|
| Rate for Payer: Cofinity Commercial |
$1,849.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,935.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,505.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,612.57
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.58
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.57
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,827.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,354.56
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$795.53
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,612.57
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
IP
|
$2,150.09
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$946.04 |
| Max. Negotiated Rate |
$1,935.08 |
| Rate for Payer: Aetna American Axle |
$1,397.56
|
| Rate for Payer: Aetna Commercial |
$1,827.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.56
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cofinity Advantage |
$1,505.06
|
| Rate for Payer: Cofinity Commercial |
$1,849.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.07
|
| Rate for Payer: Healthscope Commercial |
$1,935.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,505.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,612.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.57
|
| Rate for Payer: PHP Commercial |
$1,827.58
|
| Rate for Payer: Priority Health SBD |
$1,354.56
|
| Rate for Payer: UMR Bronson Commercial |
$946.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,612.57
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$73.24 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna American Axle |
$108.20
|
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.20
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Advantage |
$116.52
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health SBD |
$104.87
|
| Rate for Payer: UMR Bronson Commercial |
$73.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna American Axle |
$108.20
|
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: BCBS Complete |
$9.87
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$20.79
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Advantage |
$116.52
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Meridian Medicaid |
$18.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$26.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.98
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health SBD |
$104.87
|
| Rate for Payer: Priority Health Tiered Network |
$14.38
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.97
|
| Rate for Payer: UHC Core |
$26.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.98
|
| Rate for Payer: UHC Exchange |
$26.97
|
| Rate for Payer: UHC Medicaid |
$9.40
|
| Rate for Payer: UHCCP Medicaid |
$9.40
|
| Rate for Payer: UMR Bronson Commercial |
$61.59
|
| Rate for Payer: VA VA |
$17.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, 1 MILLICURIE
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
HCPCS A9607
|
| Hospital Charge Code |
34300040
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$120.25 |
| Max. Negotiated Rate |
$806.92 |
| Rate for Payer: Aetna American Axle |
$211.25
|
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: Aetna Medicare |
$269.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$324.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$324.50
|
| Rate for Payer: BCBS Complete |
$142.57
|
| Rate for Payer: BCBS MAPPO |
$259.60
|
| Rate for Payer: BCBS Trust/PPO |
$394.36
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Medicare Advantage |
$259.60
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Advantage |
$227.50
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.60
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$227.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.75
|
| Rate for Payer: Mclaren Medicaid |
$259.60
|
| Rate for Payer: Mclaren Medicare |
$259.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.58
|
| Rate for Payer: Meridian Medicaid |
$272.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$298.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$285.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.25
|
| Rate for Payer: Nomi Health Commercial |
$778.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE Medicare |
$246.62
|
| Rate for Payer: PACE SWMI |
$259.60
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: PHP Medicare Advantage |
$259.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$806.92
|
| Rate for Payer: Priority Health Medicare |
$259.60
|
| Rate for Payer: Priority Health SBD |
$204.75
|
| Rate for Payer: Priority Health Tiered Network |
$645.54
|
| Rate for Payer: Railroad Medicare Medicare |
$259.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.88
|
| Rate for Payer: UHC Core |
$427.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$259.60
|
| Rate for Payer: UHC Exchange |
$427.88
|
| Rate for Payer: UHC Medicaid |
$135.77
|
| Rate for Payer: UHCCP Medicaid |
$135.77
|
| Rate for Payer: UMR Bronson Commercial |
$120.25
|
| Rate for Payer: VA VA |
$259.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.75
|
|
|
HC LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, 1 MILLICURIE
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
HCPCS A9607
|
| Hospital Charge Code |
34300040
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna American Axle |
$211.25
|
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.25
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Advantage |
$227.50
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$227.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: Priority Health SBD |
$204.75
|
| Rate for Payer: UMR Bronson Commercial |
$143.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.75
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
OP
|
$317.32
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$285.59 |
| Rate for Payer: Aetna American Axle |
$206.26
|
| Rate for Payer: Aetna Commercial |
$269.72
|
| Rate for Payer: Aetna Medicare |
$54.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$77.11
|
| Rate for Payer: BCCCP Commercial |
$67.27
|
| Rate for Payer: BCN Commercial |
$77.11
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cofinity Advantage |
$222.12
|
| Rate for Payer: Cofinity Commercial |
$272.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$285.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.99
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$54.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.72
|
| Rate for Payer: Nomi Health Commercial |
$155.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.99
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$269.72
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.92
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health SBD |
$199.91
|
| Rate for Payer: Priority Health Tiered Network |
$134.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.15
|
| Rate for Payer: UHC Core |
$80.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.15
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: UMR Bronson Commercial |
$117.41
|
| Rate for Payer: VA VA |
$51.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.99
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
IP
|
$317.32
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$139.62 |
| Max. Negotiated Rate |
$285.59 |
| Rate for Payer: Aetna American Axle |
$206.26
|
| Rate for Payer: Aetna Commercial |
$269.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.26
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cofinity Advantage |
$222.12
|
| Rate for Payer: Cofinity Commercial |
$272.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.86
|
| Rate for Payer: Healthscope Commercial |
$285.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.99
|
| Rate for Payer: PHP Commercial |
$269.72
|
| Rate for Payer: Priority Health SBD |
$199.91
|
| Rate for Payer: UMR Bronson Commercial |
$139.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.99
|
|
|
HC LVAD INSERTION
|
Facility
|
OP
|
$3,288.11
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,216.60 |
| Max. Negotiated Rate |
$2,959.30 |
| Rate for Payer: Aetna American Axle |
$2,137.27
|
| Rate for Payer: Aetna Commercial |
$2,794.89
|
| Rate for Payer: Aetna Medicare |
$1,644.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.27
|
| Rate for Payer: BCBS Complete |
$1,315.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,894.26
|
| Rate for Payer: BCN Commercial |
$1,894.26
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cofinity Advantage |
$2,301.68
|
| Rate for Payer: Cofinity Commercial |
$2,827.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.49
|
| Rate for Payer: Healthscope Commercial |
$2,959.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,301.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,630.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.08
|
| Rate for Payer: PHP Commercial |
$2,794.89
|
| Rate for Payer: Priority Health SBD |
$2,071.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.08
|
|
|
HC LVAD INSERTION
|
Facility
|
IP
|
$3,288.11
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,446.77 |
| Max. Negotiated Rate |
$2,959.30 |
| Rate for Payer: Aetna American Axle |
$2,137.27
|
| Rate for Payer: Aetna Commercial |
$2,794.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,137.27
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cofinity Advantage |
$2,301.68
|
| Rate for Payer: Cofinity Commercial |
$2,827.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.49
|
| Rate for Payer: Healthscope Commercial |
$2,959.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,301.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.08
|
| Rate for Payer: PHP Commercial |
$2,794.89
|
| Rate for Payer: Priority Health SBD |
$2,071.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,446.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.08
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
IP
|
$2,889.46
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,271.36 |
| Max. Negotiated Rate |
$2,600.51 |
| Rate for Payer: Aetna American Axle |
$1,878.15
|
| Rate for Payer: Aetna Commercial |
$2,456.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,878.15
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cofinity Advantage |
$2,022.62
|
| Rate for Payer: Cofinity Commercial |
$2,484.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,311.57
|
| Rate for Payer: Healthscope Commercial |
$2,600.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,022.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,167.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,167.09
|
| Rate for Payer: PHP Commercial |
$2,456.04
|
| Rate for Payer: Priority Health SBD |
$1,820.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,271.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,167.09
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
OP
|
$2,889.46
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$347.16 |
| Max. Negotiated Rate |
$2,600.51 |
| Rate for Payer: Aetna American Axle |
$1,878.15
|
| Rate for Payer: Aetna Commercial |
$2,456.04
|
| Rate for Payer: Aetna Medicare |
$690.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,878.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$829.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$829.74
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$663.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.32
|
| Rate for Payer: BCN Commercial |
$1,787.32
|
| Rate for Payer: BCN Medicare Advantage |
$663.79
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cofinity Advantage |
$2,022.62
|
| Rate for Payer: Cofinity Commercial |
$2,484.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,311.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.79
|
| Rate for Payer: Healthscope Commercial |
$2,600.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,022.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,167.09
|
| Rate for Payer: Mclaren Medicaid |
$663.79
|
| Rate for Payer: Mclaren Medicare |
$663.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.98
|
| Rate for Payer: Meridian Medicaid |
$696.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$763.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$730.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.04
|
| Rate for Payer: Nomi Health Commercial |
$1,991.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,167.09
|
| Rate for Payer: PACE Medicare |
$630.60
|
| Rate for Payer: PACE SWMI |
$663.79
|
| Rate for Payer: PHP Commercial |
$2,456.04
|
| Rate for Payer: PHP Medicare Advantage |
$663.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,146.63
|
| Rate for Payer: Priority Health Medicare |
$663.79
|
| Rate for Payer: Priority Health SBD |
$1,820.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,717.30
|
| Rate for Payer: Railroad Medicare Medicare |
$663.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,878.15
|
| Rate for Payer: UHC Core |
$1,505.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$663.79
|
| Rate for Payer: UHC Exchange |
$1,135.56
|
| Rate for Payer: UHC Medicaid |
$347.16
|
| Rate for Payer: UHCCP Medicaid |
$347.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,069.10
|
| Rate for Payer: VA VA |
$663.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,167.09
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
OP
|
$2,244.05
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$260.95 |
| Max. Negotiated Rate |
$2,019.64 |
| Rate for Payer: Aetna American Axle |
$1,458.63
|
| Rate for Payer: Aetna Commercial |
$1,907.44
|
| Rate for Payer: Aetna Medicare |
$518.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.67
|
| Rate for Payer: BCBS Complete |
$274.02
|
| Rate for Payer: BCBS MAPPO |
$498.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.53
|
| Rate for Payer: BCN Commercial |
$1,288.53
|
| Rate for Payer: BCN Medicare Advantage |
$498.94
|
| Rate for Payer: Cash Price |
$1,795.24
|
| Rate for Payer: Cash Price |
$1,795.24
|
| Rate for Payer: Cofinity Advantage |
$1,570.84
|
| Rate for Payer: Cofinity Commercial |
$1,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,795.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.94
|
| Rate for Payer: Healthscope Commercial |
$2,019.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,570.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,683.04
|
| Rate for Payer: Mclaren Medicaid |
$498.94
|
| Rate for Payer: Mclaren Medicare |
$498.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.89
|
| Rate for Payer: Meridian Medicaid |
$523.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,907.44
|
| Rate for Payer: Nomi Health Commercial |
$1,496.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.04
|
| Rate for Payer: PACE Medicare |
$473.99
|
| Rate for Payer: PACE SWMI |
$498.94
|
| Rate for Payer: PHP Commercial |
$1,907.44
|
| Rate for Payer: PHP Medicare Advantage |
$498.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,613.55
|
| Rate for Payer: Priority Health Medicare |
$498.94
|
| Rate for Payer: Priority Health SBD |
$1,413.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,290.84
|
| Rate for Payer: Railroad Medicare Medicare |
$498.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,458.63
|
| Rate for Payer: UHC Core |
$1,169.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.94
|
| Rate for Payer: UHC Exchange |
$881.91
|
| Rate for Payer: UHC Medicaid |
$260.95
|
| Rate for Payer: UHCCP Medicaid |
$260.95
|
| Rate for Payer: UMR Bronson Commercial |
$830.30
|
| Rate for Payer: VA VA |
$498.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,683.04
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
IP
|
$2,244.05
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$987.38 |
| Max. Negotiated Rate |
$2,019.64 |
| Rate for Payer: Aetna American Axle |
$1,458.63
|
| Rate for Payer: Aetna Commercial |
$1,907.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,458.63
|
| Rate for Payer: Cash Price |
$1,795.24
|
| Rate for Payer: Cofinity Advantage |
$1,570.84
|
| Rate for Payer: Cofinity Commercial |
$1,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,795.24
|
| Rate for Payer: Healthscope Commercial |
$2,019.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,570.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,683.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,907.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.04
|
| Rate for Payer: PHP Commercial |
$1,907.44
|
| Rate for Payer: Priority Health SBD |
$1,413.75
|
| Rate for Payer: UMR Bronson Commercial |
$987.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,683.04
|
|
|
HC LV LEAD PLACEMENT
|
Facility
|
OP
|
$9,737.48
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,602.87 |
| Max. Negotiated Rate |
$22,162.24 |
| Rate for Payer: Aetna American Axle |
$6,329.36
|
| Rate for Payer: Aetna Commercial |
$8,276.86
|
| Rate for Payer: Aetna Medicare |
$4,868.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,329.36
|
| Rate for Payer: BCBS Complete |
$3,894.99
|
| Rate for Payer: BCBS Trust/PPO |
$22,162.24
|
| Rate for Payer: BCN Commercial |
$22,162.24
|
| Rate for Payer: Cash Price |
$7,789.98
|
| Rate for Payer: Cash Price |
$7,789.98
|
| Rate for Payer: Cash Price |
$7,789.98
|
| Rate for Payer: Cofinity Advantage |
$6,816.24
|
| Rate for Payer: Cofinity Commercial |
$8,374.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,789.98
|
| Rate for Payer: Healthscope Commercial |
$8,763.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,816.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,303.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,789.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,276.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,303.11
|
| Rate for Payer: PHP Commercial |
$8,276.86
|
| Rate for Payer: Priority Health SBD |
$6,134.61
|
| Rate for Payer: UMR Bronson Commercial |
$3,602.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,303.11
|
|
