|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
OP
|
$831.27
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$307.57 |
| Max. Negotiated Rate |
$748.14 |
| Rate for Payer: Aetna American Axle |
$540.33
|
| Rate for Payer: Aetna Commercial |
$706.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.33
|
| Rate for Payer: BCBS Complete |
$332.51
|
| Rate for Payer: Cash Price |
$665.02
|
| Rate for Payer: Cofinity Commercial |
$581.89
|
| Rate for Payer: Cofinity Commercial |
$714.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$665.02
|
| Rate for Payer: Healthscope Commercial |
$748.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$581.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$623.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$706.58
|
| Rate for Payer: PHP Commercial |
$706.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.89
|
| Rate for Payer: Priority Health SBD |
$523.70
|
| Rate for Payer: UMR Bronson Commercial |
$307.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$623.45
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
IP
|
$831.27
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$365.76 |
| Max. Negotiated Rate |
$748.14 |
| Rate for Payer: Aetna American Axle |
$540.33
|
| Rate for Payer: Aetna Commercial |
$706.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.33
|
| Rate for Payer: Cash Price |
$665.02
|
| Rate for Payer: Cofinity Commercial |
$581.89
|
| Rate for Payer: Cofinity Commercial |
$714.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$665.02
|
| Rate for Payer: Healthscope Commercial |
$748.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$581.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$623.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$706.58
|
| Rate for Payer: PHP Commercial |
$706.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.89
|
| Rate for Payer: Priority Health SBD |
$523.70
|
| Rate for Payer: UMR Bronson Commercial |
$365.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$623.45
|
|
|
HC THORACENT WO TUBE
|
Facility
|
OP
|
$1,088.19
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.78 |
| Max. Negotiated Rate |
$1,757.86 |
| Rate for Payer: Aetna American Axle |
$707.32
|
| Rate for Payer: Aetna Commercial |
$924.96
|
| Rate for Payer: Aetna Medicare |
$580.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$695.54
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$870.55
|
| Rate for Payer: Cash Price |
$870.55
|
| Rate for Payer: Cofinity Commercial |
$761.73
|
| Rate for Payer: Cofinity Commercial |
$935.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$979.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$761.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.14
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$924.96
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$924.96
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.86
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.29
|
| Rate for Payer: Priority Health SBD |
$685.56
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.40
|
| Rate for Payer: UHC Exchange |
$104.78
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: UMR Bronson Commercial |
$402.63
|
| Rate for Payer: VA VA |
$558.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.14
|
|
|
HC THORACENT WO TUBE
|
Facility
|
IP
|
$1,088.19
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$979.37 |
| Rate for Payer: Aetna American Axle |
$707.32
|
| Rate for Payer: Aetna Commercial |
$924.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.32
|
| Rate for Payer: Cash Price |
$870.55
|
| Rate for Payer: Cofinity Commercial |
$761.73
|
| Rate for Payer: Cofinity Commercial |
$935.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.55
|
| Rate for Payer: Healthscope Commercial |
$979.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$761.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$924.96
|
| Rate for Payer: PHP Commercial |
$924.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.73
|
| Rate for Payer: Priority Health SBD |
$685.56
|
| Rate for Payer: UMR Bronson Commercial |
$478.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.14
|
|
|
HC THORACENT W TUBE
|
Facility
|
OP
|
$1,386.74
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.09 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$901.38
|
| Rate for Payer: Aetna Commercial |
$1,178.73
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$434.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,109.39
|
| Rate for Payer: Cash Price |
$1,109.39
|
| Rate for Payer: Cofinity Commercial |
$1,192.60
|
| Rate for Payer: Cofinity Commercial |
$970.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,109.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,248.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$970.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,040.06
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,178.73
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,178.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$873.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.40
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$143.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$513.09
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,040.06
|
|
|
HC THORACENT W TUBE
|
Facility
|
IP
|
$1,386.74
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$610.17 |
| Max. Negotiated Rate |
$1,248.07 |
| Rate for Payer: Aetna American Axle |
$901.38
|
| Rate for Payer: Aetna Commercial |
$1,178.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.38
|
| Rate for Payer: Cash Price |
$1,109.39
|
| Rate for Payer: Cofinity Commercial |
$1,192.60
|
| Rate for Payer: Cofinity Commercial |
$970.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,109.39
|
| Rate for Payer: Healthscope Commercial |
$1,248.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$970.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,040.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,178.73
|
| Rate for Payer: PHP Commercial |
$1,178.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.72
|
| Rate for Payer: Priority Health SBD |
$873.65
|
| Rate for Payer: UMR Bronson Commercial |
$610.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,040.06
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
IP
|
$691.08
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$304.08 |
| Max. Negotiated Rate |
$621.97 |
| Rate for Payer: Aetna American Axle |
$449.20
|
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.20
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cofinity Commercial |
$483.76
|
| Rate for Payer: Cofinity Commercial |
$594.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.86
|
| Rate for Payer: Healthscope Commercial |
$621.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$483.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.42
|
| Rate for Payer: PHP Commercial |
$587.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.76
|
| Rate for Payer: Priority Health SBD |
$435.38
|
| Rate for Payer: UMR Bronson Commercial |
$304.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.31
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
OP
|
$691.08
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$55.01 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$449.20
|
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$212.79
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cofinity Commercial |
$483.76
|
| Rate for Payer: Cofinity Commercial |
$594.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$621.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$483.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.31
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.42
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$587.42
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$435.38
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.51
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$55.01
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$255.70
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.31
|
|
|
HC THORACOTOMY
|
Facility
|
IP
|
$2,050.86
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$902.38 |
| Max. Negotiated Rate |
$1,845.77 |
| Rate for Payer: Aetna American Axle |
$1,333.06
|
| Rate for Payer: Aetna Commercial |
$1,743.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.06
|
| Rate for Payer: Cash Price |
$1,640.69
|
| Rate for Payer: Cofinity Commercial |
$1,435.60
|
| Rate for Payer: Cofinity Commercial |
$1,763.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.69
|
| Rate for Payer: Healthscope Commercial |
$1,845.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,435.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,538.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.23
|
| Rate for Payer: PHP Commercial |
$1,743.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.60
|
| Rate for Payer: Priority Health SBD |
$1,292.04
|
| Rate for Payer: UMR Bronson Commercial |
$902.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,538.14
|
|
|
HC THORACOTOMY
|
Facility
|
OP
|
$2,050.86
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$758.82 |
| Max. Negotiated Rate |
$1,845.77 |
| Rate for Payer: Aetna American Axle |
$1,333.06
|
| Rate for Payer: Aetna Commercial |
$1,743.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.06
|
| Rate for Payer: BCBS Complete |
$820.34
|
| Rate for Payer: Cash Price |
$1,640.69
|
| Rate for Payer: Cofinity Commercial |
$1,435.60
|
| Rate for Payer: Cofinity Commercial |
$1,763.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.69
|
| Rate for Payer: Healthscope Commercial |
$1,845.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,435.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,538.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.23
|
| Rate for Payer: PHP Commercial |
$1,743.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.60
|
| Rate for Payer: Priority Health SBD |
$1,292.04
|
| Rate for Payer: UMR Bronson Commercial |
$758.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,538.14
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
OP
|
$4,870.71
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$824.17 |
| Max. Negotiated Rate |
$4,383.64 |
| Rate for Payer: Aetna American Axle |
$3,165.96
|
| Rate for Payer: Aetna Commercial |
$4,140.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,165.96
|
| Rate for Payer: BCBS Complete |
$1,948.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,075.70
|
| Rate for Payer: Cash Price |
$3,896.57
|
| Rate for Payer: Cash Price |
$3,896.57
|
| Rate for Payer: Cofinity Commercial |
$3,409.50
|
| Rate for Payer: Cofinity Commercial |
$4,188.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,896.57
|
| Rate for Payer: Healthscope Commercial |
$4,383.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,409.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,653.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,140.10
|
| Rate for Payer: PHP Commercial |
$4,140.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,409.50
|
| Rate for Payer: Priority Health SBD |
$3,068.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$906.59
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$824.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,802.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,653.03
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
IP
|
$4,870.71
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,143.11 |
| Max. Negotiated Rate |
$4,383.64 |
| Rate for Payer: Aetna American Axle |
$3,165.96
|
| Rate for Payer: Aetna Commercial |
$4,140.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,165.96
|
| Rate for Payer: Cash Price |
$3,896.57
|
| Rate for Payer: Cofinity Commercial |
$3,409.50
|
| Rate for Payer: Cofinity Commercial |
$4,188.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,896.57
|
| Rate for Payer: Healthscope Commercial |
$4,383.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,409.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,653.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,140.10
|
| Rate for Payer: PHP Commercial |
$4,140.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,409.50
|
| Rate for Payer: Priority Health SBD |
$3,068.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,143.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,653.03
|
|
|
HC THROMBIN TIME
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500062
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: UMR Bronson Commercial |
$32.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC THROMBIN TIME
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500062
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.21
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$5.77
|
| Rate for Payer: BCBS Trust/PPO |
$5.19
|
| Rate for Payer: BCN Medicare Advantage |
$5.77
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.77
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$3.16
|
| Rate for Payer: Mclaren Medicare |
$5.77
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PACE Medicare |
$5.48
|
| Rate for Payer: PACE SWMI |
$5.77
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$5.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.91
|
| Rate for Payer: Priority Health Medicare |
$5.77
|
| Rate for Payer: Priority Health Narrow Network |
$6.33
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.92
|
| Rate for Payer: UHC Core |
$9.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.77
|
| Rate for Payer: UHC Exchange |
$5.77
|
| Rate for Payer: UHC Medicare Advantage |
$5.94
|
| Rate for Payer: UMR Bronson Commercial |
$27.55
|
| Rate for Payer: VA VA |
$5.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC THROMBO EMBO CATHETER LVL 1
|
Facility
|
IP
|
$102.93
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.29 |
| Max. Negotiated Rate |
$92.64 |
| Rate for Payer: Aetna American Axle |
$66.90
|
| Rate for Payer: Aetna Commercial |
$87.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.90
|
| Rate for Payer: Cash Price |
$82.34
|
| Rate for Payer: Cofinity Commercial |
$72.05
|
| Rate for Payer: Cofinity Commercial |
$88.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.34
|
| Rate for Payer: Healthscope Commercial |
$92.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.49
|
| Rate for Payer: PHP Commercial |
$87.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.05
|
| Rate for Payer: Priority Health SBD |
$64.85
|
| Rate for Payer: UMR Bronson Commercial |
$45.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.20
|
|
|
HC THROMBO EMBO CATHETER LVL 1
|
Facility
|
OP
|
$102.93
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.08 |
| Max. Negotiated Rate |
$92.64 |
| Rate for Payer: Aetna American Axle |
$66.90
|
| Rate for Payer: Aetna Commercial |
$87.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.90
|
| Rate for Payer: BCBS Complete |
$41.17
|
| Rate for Payer: Cash Price |
$82.34
|
| Rate for Payer: Cofinity Commercial |
$72.05
|
| Rate for Payer: Cofinity Commercial |
$88.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.34
|
| Rate for Payer: Healthscope Commercial |
$92.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.49
|
| Rate for Payer: PHP Commercial |
$87.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.05
|
| Rate for Payer: Priority Health SBD |
$64.85
|
| Rate for Payer: UMR Bronson Commercial |
$38.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.20
|
|
|
HC THROMBO EMBO CATHETER LVL 10
|
Facility
|
OP
|
$1,023.75
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200282
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.79 |
| Max. Negotiated Rate |
$921.38 |
| Rate for Payer: Aetna American Axle |
$665.44
|
| Rate for Payer: Aetna Commercial |
$870.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.44
|
| Rate for Payer: BCBS Complete |
$409.50
|
| Rate for Payer: Cash Price |
$819.00
|
| Rate for Payer: Cofinity Commercial |
$716.62
|
| Rate for Payer: Cofinity Commercial |
$880.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.00
|
| Rate for Payer: Healthscope Commercial |
$921.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$767.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$870.19
|
| Rate for Payer: PHP Commercial |
$870.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.62
|
| Rate for Payer: Priority Health SBD |
$644.96
|
| Rate for Payer: UMR Bronson Commercial |
$378.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$767.81
|
|
|
HC THROMBO EMBO CATHETER LVL 10
|
Facility
|
IP
|
$1,023.75
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200282
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$450.45 |
| Max. Negotiated Rate |
$921.38 |
| Rate for Payer: Aetna American Axle |
$665.44
|
| Rate for Payer: Aetna Commercial |
$870.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.44
|
| Rate for Payer: Cash Price |
$819.00
|
| Rate for Payer: Cofinity Commercial |
$716.62
|
| Rate for Payer: Cofinity Commercial |
$880.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.00
|
| Rate for Payer: Healthscope Commercial |
$921.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$767.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$870.19
|
| Rate for Payer: PHP Commercial |
$870.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.62
|
| Rate for Payer: Priority Health SBD |
$644.96
|
| Rate for Payer: UMR Bronson Commercial |
$450.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$767.81
|
|
|
HC THROMBO EMBO CATHETER LVL 13
|
Facility
|
OP
|
$1,339.02
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$495.44 |
| Max. Negotiated Rate |
$1,205.12 |
| Rate for Payer: Aetna American Axle |
$870.36
|
| Rate for Payer: Aetna Commercial |
$1,138.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$870.36
|
| Rate for Payer: BCBS Complete |
$535.61
|
| Rate for Payer: Cash Price |
$1,071.22
|
| Rate for Payer: Cofinity Commercial |
$1,151.56
|
| Rate for Payer: Cofinity Commercial |
$937.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,071.22
|
| Rate for Payer: Healthscope Commercial |
$1,205.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$937.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,004.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,138.17
|
| Rate for Payer: PHP Commercial |
$1,138.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$937.31
|
| Rate for Payer: Priority Health SBD |
$843.58
|
| Rate for Payer: UMR Bronson Commercial |
$495.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,004.26
|
|
|
HC THROMBO EMBO CATHETER LVL 13
|
Facility
|
IP
|
$1,339.02
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$589.17 |
| Max. Negotiated Rate |
$1,205.12 |
| Rate for Payer: Aetna American Axle |
$870.36
|
| Rate for Payer: Aetna Commercial |
$1,138.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$870.36
|
| Rate for Payer: Cash Price |
$1,071.22
|
| Rate for Payer: Cofinity Commercial |
$1,151.56
|
| Rate for Payer: Cofinity Commercial |
$937.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,071.22
|
| Rate for Payer: Healthscope Commercial |
$1,205.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$937.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,004.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,138.17
|
| Rate for Payer: PHP Commercial |
$1,138.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$937.31
|
| Rate for Payer: Priority Health SBD |
$843.58
|
| Rate for Payer: UMR Bronson Commercial |
$589.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,004.26
|
|
|
HC THROMBO EMBO CATHETER LVL 14
|
Facility
|
IP
|
$1,456.71
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$640.95 |
| Max. Negotiated Rate |
$1,311.04 |
| Rate for Payer: Aetna American Axle |
$946.86
|
| Rate for Payer: Aetna Commercial |
$1,238.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$946.86
|
| Rate for Payer: Cash Price |
$1,165.37
|
| Rate for Payer: Cofinity Commercial |
$1,019.70
|
| Rate for Payer: Cofinity Commercial |
$1,252.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,165.37
|
| Rate for Payer: Healthscope Commercial |
$1,311.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,019.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,092.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,238.20
|
| Rate for Payer: PHP Commercial |
$1,238.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.70
|
| Rate for Payer: Priority Health SBD |
$917.73
|
| Rate for Payer: UMR Bronson Commercial |
$640.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,092.53
|
|
|
HC THROMBO EMBO CATHETER LVL 14
|
Facility
|
OP
|
$1,456.71
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$538.98 |
| Max. Negotiated Rate |
$1,311.04 |
| Rate for Payer: Aetna American Axle |
$946.86
|
| Rate for Payer: Aetna Commercial |
$1,238.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$946.86
|
| Rate for Payer: BCBS Complete |
$582.68
|
| Rate for Payer: Cash Price |
$1,165.37
|
| Rate for Payer: Cofinity Commercial |
$1,019.70
|
| Rate for Payer: Cofinity Commercial |
$1,252.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,165.37
|
| Rate for Payer: Healthscope Commercial |
$1,311.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,019.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,092.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,238.20
|
| Rate for Payer: PHP Commercial |
$1,238.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.70
|
| Rate for Payer: Priority Health SBD |
$917.73
|
| Rate for Payer: UMR Bronson Commercial |
$538.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,092.53
|
|
|
HC THROMBO EMBO CATHETER LVL 33
|
Facility
|
OP
|
$3,302.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,221.74 |
| Max. Negotiated Rate |
$2,971.80 |
| Rate for Payer: Aetna American Axle |
$2,146.30
|
| Rate for Payer: Aetna Commercial |
$2,806.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,146.30
|
| Rate for Payer: BCBS Complete |
$1,320.80
|
| Rate for Payer: Cash Price |
$2,641.60
|
| Rate for Payer: Cofinity Commercial |
$2,311.40
|
| Rate for Payer: Cofinity Commercial |
$2,839.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.60
|
| Rate for Payer: Healthscope Commercial |
$2,971.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,311.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,476.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.70
|
| Rate for Payer: PHP Commercial |
$2,806.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.40
|
| Rate for Payer: Priority Health SBD |
$2,080.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,221.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,476.50
|
|
|
HC THROMBO EMBO CATHETER LVL 33
|
Facility
|
IP
|
$3,302.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,452.88 |
| Max. Negotiated Rate |
$2,971.80 |
| Rate for Payer: Aetna American Axle |
$2,146.30
|
| Rate for Payer: Aetna Commercial |
$2,806.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,146.30
|
| Rate for Payer: Cash Price |
$2,641.60
|
| Rate for Payer: Cofinity Commercial |
$2,311.40
|
| Rate for Payer: Cofinity Commercial |
$2,839.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.60
|
| Rate for Payer: Healthscope Commercial |
$2,971.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,311.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,476.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.70
|
| Rate for Payer: PHP Commercial |
$2,806.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.40
|
| Rate for Payer: Priority Health SBD |
$2,080.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,452.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,476.50
|
|
|
HC THROMBO EMBO CATHETER LVL 46
|
Facility
|
OP
|
$4,610.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,705.70 |
| Max. Negotiated Rate |
$4,149.00 |
| Rate for Payer: Aetna American Axle |
$2,996.50
|
| Rate for Payer: Aetna Commercial |
$3,918.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,996.50
|
| Rate for Payer: BCBS Complete |
$1,844.00
|
| Rate for Payer: Cash Price |
$3,688.00
|
| Rate for Payer: Cofinity Commercial |
$3,227.00
|
| Rate for Payer: Cofinity Commercial |
$3,964.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,688.00
|
| Rate for Payer: Healthscope Commercial |
$4,149.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,227.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,457.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,918.50
|
| Rate for Payer: PHP Commercial |
$3,918.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,227.00
|
| Rate for Payer: Priority Health SBD |
$2,904.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,705.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,457.50
|
|
