|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.11
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$369.91 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$122.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: BCBS Complete |
$67.49
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Mclaren Medicare |
$117.50
|
| Rate for Payer: Meridian Medicaid |
$67.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.70
|
| Rate for Payer: PACE Medicare |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.91
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow Network |
$295.93
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
| Rate for Payer: UHC Exchange |
$185.00
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: UMR Bronson Commercial |
$43.40
|
| Rate for Payer: VA VA |
$117.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$24,480.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$461.04 |
| Max. Negotiated Rate |
$54,524.10 |
| Rate for Payer: Aetna American Axle |
$15,912.00
|
| Rate for Payer: Aetna Commercial |
$20,808.00
|
| Rate for Payer: Aetna Medicare |
$18,012.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,912.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,649.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,649.99
|
| Rate for Payer: BCBS Complete |
$9,948.60
|
| Rate for Payer: BCBS MAPPO |
$17,319.99
|
| Rate for Payer: BCBS Trust/PPO |
$17,517.56
|
| Rate for Payer: BCN Medicare Advantage |
$17,319.99
|
| Rate for Payer: Cash Price |
$19,584.00
|
| Rate for Payer: Cash Price |
$19,584.00
|
| Rate for Payer: Cofinity Commercial |
$17,136.00
|
| Rate for Payer: Cofinity Commercial |
$21,052.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,584.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,319.99
|
| Rate for Payer: Healthscope Commercial |
$22,032.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,136.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,360.00
|
| Rate for Payer: Mclaren Medicaid |
$9,474.03
|
| Rate for Payer: Mclaren Medicare |
$17,319.99
|
| Rate for Payer: Meridian Medicaid |
$9,948.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,185.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,917.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,808.00
|
| Rate for Payer: PACE Medicare |
$16,453.99
|
| Rate for Payer: PACE SWMI |
$17,319.99
|
| Rate for Payer: PHP Commercial |
$20,808.00
|
| Rate for Payer: PHP Medicare Advantage |
$17,319.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,474.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,136.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54,524.10
|
| Rate for Payer: Priority Health Medicare |
$17,319.99
|
| Rate for Payer: Priority Health Narrow Network |
$43,619.28
|
| Rate for Payer: Priority Health SBD |
$15,422.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17,319.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.14
|
| Rate for Payer: UHC Core |
$30,600.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,319.99
|
| Rate for Payer: UHC Exchange |
$461.04
|
| Rate for Payer: UHC Medicare Advantage |
$17,839.59
|
| Rate for Payer: UMR Bronson Commercial |
$9,057.60
|
| Rate for Payer: VA VA |
$17,319.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,360.00
|
|
|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$24,480.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,771.20 |
| Max. Negotiated Rate |
$22,032.00 |
| Rate for Payer: Aetna American Axle |
$15,912.00
|
| Rate for Payer: Aetna Commercial |
$20,808.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,912.00
|
| Rate for Payer: Cash Price |
$19,584.00
|
| Rate for Payer: Cofinity Commercial |
$17,136.00
|
| Rate for Payer: Cofinity Commercial |
$21,052.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,584.00
|
| Rate for Payer: Healthscope Commercial |
$22,032.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,136.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,360.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,808.00
|
| Rate for Payer: PHP Commercial |
$20,808.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,136.00
|
| Rate for Payer: Priority Health SBD |
$15,422.40
|
| Rate for Payer: UMR Bronson Commercial |
$10,771.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,360.00
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
OP
|
$42,373.86
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.00 |
| Max. Negotiated Rate |
$38,136.47 |
| Rate for Payer: Aetna American Axle |
$27,543.01
|
| Rate for Payer: Aetna Commercial |
$36,017.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27,543.01
|
| Rate for Payer: BCBS Complete |
$16,949.54
|
| Rate for Payer: Cash Price |
$33,899.09
|
| Rate for Payer: Cash Price |
$33,899.09
|
| Rate for Payer: Cofinity Commercial |
$29,661.70
|
| Rate for Payer: Cofinity Commercial |
$36,441.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33,899.09
|
| Rate for Payer: Healthscope Commercial |
$38,136.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29,661.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31,780.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36,017.78
|
| Rate for Payer: PHP Commercial |
$36,017.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29,661.70
|
| Rate for Payer: Priority Health SBD |
$26,695.53
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UMR Bronson Commercial |
$15,678.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31,780.40
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
IP
|
$42,373.86
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$18,644.50 |
| Max. Negotiated Rate |
$38,136.47 |
| Rate for Payer: Aetna American Axle |
$27,543.01
|
| Rate for Payer: Aetna Commercial |
$36,017.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27,543.01
|
| Rate for Payer: Cash Price |
$33,899.09
|
| Rate for Payer: Cofinity Commercial |
$36,441.52
|
| Rate for Payer: Cofinity Commercial |
$29,661.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33,899.09
|
| Rate for Payer: Healthscope Commercial |
$38,136.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29,661.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31,780.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36,017.78
|
| Rate for Payer: PHP Commercial |
$36,017.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29,661.70
|
| Rate for Payer: Priority Health SBD |
$26,695.53
|
| Rate for Payer: UMR Bronson Commercial |
$18,644.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31,780.40
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$3,814.80
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,678.51 |
| Max. Negotiated Rate |
$3,433.32 |
| Rate for Payer: Aetna American Axle |
$2,479.62
|
| Rate for Payer: Aetna Commercial |
$3,242.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,479.62
|
| Rate for Payer: Cash Price |
$3,051.84
|
| Rate for Payer: Cofinity Commercial |
$2,670.36
|
| Rate for Payer: Cofinity Commercial |
$3,280.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,051.84
|
| Rate for Payer: Healthscope Commercial |
$3,433.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,670.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,861.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,242.58
|
| Rate for Payer: PHP Commercial |
$3,242.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,670.36
|
| Rate for Payer: Priority Health SBD |
$2,403.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,678.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,861.10
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$3,814.80
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$487.23 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,479.62
|
| Rate for Payer: Aetna Commercial |
$3,242.58
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,479.62
|
| 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 |
$2,154.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,051.84
|
| Rate for Payer: Cash Price |
$3,051.84
|
| Rate for Payer: Cofinity Commercial |
$2,670.36
|
| Rate for Payer: Cofinity Commercial |
$3,280.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,051.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,433.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,670.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,861.10
|
| 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 |
$3,242.58
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,242.58
|
| 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 |
$2,670.36
|
| 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 |
$2,403.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.95
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$487.23
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,411.48
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,861.10
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
OP
|
$552.31
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$204.35 |
| Max. Negotiated Rate |
$497.08 |
| Rate for Payer: Aetna American Axle |
$359.00
|
| Rate for Payer: Aetna Commercial |
$469.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.00
|
| Rate for Payer: BCBS Complete |
$220.92
|
| Rate for Payer: Cash Price |
$441.85
|
| Rate for Payer: Cofinity Commercial |
$386.62
|
| Rate for Payer: Cofinity Commercial |
$474.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.85
|
| Rate for Payer: Healthscope Commercial |
$497.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$469.46
|
| Rate for Payer: PHP Commercial |
$469.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.62
|
| Rate for Payer: Priority Health SBD |
$347.96
|
| Rate for Payer: UMR Bronson Commercial |
$204.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.23
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
IP
|
$552.31
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$243.02 |
| Max. Negotiated Rate |
$497.08 |
| Rate for Payer: Aetna American Axle |
$359.00
|
| Rate for Payer: Aetna Commercial |
$469.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.00
|
| Rate for Payer: Cash Price |
$441.85
|
| Rate for Payer: Cofinity Commercial |
$386.62
|
| Rate for Payer: Cofinity Commercial |
$474.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.85
|
| Rate for Payer: Healthscope Commercial |
$497.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$469.46
|
| Rate for Payer: PHP Commercial |
$469.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.62
|
| Rate for Payer: Priority Health SBD |
$347.96
|
| Rate for Payer: UMR Bronson Commercial |
$243.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.23
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
OP
|
$1,586.54
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,427.89 |
| Rate for Payer: Aetna American Axle |
$1,031.25
|
| Rate for Payer: Aetna Commercial |
$1,348.56
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.03
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,269.23
|
| Rate for Payer: Cash Price |
$1,269.23
|
| Rate for Payer: Cash Price |
$1,269.23
|
| Rate for Payer: Cofinity Commercial |
$1,364.42
|
| Rate for Payer: Cofinity Commercial |
$1,110.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,427.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.90
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.56
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,348.56
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$999.52
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.43
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$269.48
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$587.02
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.90
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
IP
|
$1,586.54
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$698.08 |
| Max. Negotiated Rate |
$1,427.89 |
| Rate for Payer: Aetna American Axle |
$1,031.25
|
| Rate for Payer: Aetna Commercial |
$1,348.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.25
|
| Rate for Payer: Cash Price |
$1,269.23
|
| Rate for Payer: Cofinity Commercial |
$1,110.58
|
| Rate for Payer: Cofinity Commercial |
$1,364.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.23
|
| Rate for Payer: Healthscope Commercial |
$1,427.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,110.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,189.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,348.56
|
| Rate for Payer: PHP Commercial |
$1,348.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.58
|
| Rate for Payer: Priority Health SBD |
$999.52
|
| Rate for Payer: UMR Bronson Commercial |
$698.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,189.90
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
IP
|
$599.45
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$263.76 |
| Max. Negotiated Rate |
$539.50 |
| Rate for Payer: Aetna American Axle |
$389.64
|
| Rate for Payer: Aetna Commercial |
$509.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$389.64
|
| Rate for Payer: Cash Price |
$479.56
|
| Rate for Payer: Cofinity Commercial |
$419.62
|
| Rate for Payer: Cofinity Commercial |
$515.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.56
|
| Rate for Payer: Healthscope Commercial |
$539.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$419.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$449.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$509.53
|
| Rate for Payer: PHP Commercial |
$509.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.62
|
| Rate for Payer: Priority Health SBD |
$377.65
|
| Rate for Payer: UMR Bronson Commercial |
$263.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$449.59
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
OP
|
$599.45
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$675.25 |
| Rate for Payer: Aetna American Axle |
$389.64
|
| Rate for Payer: Aetna Commercial |
$509.53
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$389.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$675.25
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$479.56
|
| Rate for Payer: Cash Price |
$479.56
|
| Rate for Payer: Cash Price |
$479.56
|
| Rate for Payer: Cofinity Commercial |
$419.62
|
| Rate for Payer: Cofinity Commercial |
$515.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$539.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$419.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$449.59
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$509.53
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$509.53
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$377.65
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.52
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$156.84
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$221.80
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$449.59
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$158.75 |
| Max. Negotiated Rate |
$1,499.80 |
| Rate for Payer: Aetna American Axle |
$278.88
|
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$812.68
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.93
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Exchange |
$239.03
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$158.75
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$188.78 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna American Axle |
$278.88
|
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: UMR Bronson Commercial |
$188.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
IP
|
$613.96
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$270.14 |
| Max. Negotiated Rate |
$552.56 |
| Rate for Payer: Aetna American Axle |
$399.07
|
| Rate for Payer: Aetna Commercial |
$521.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.07
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cofinity Commercial |
$429.77
|
| Rate for Payer: Cofinity Commercial |
$528.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.17
|
| Rate for Payer: Healthscope Commercial |
$552.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$429.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.87
|
| Rate for Payer: PHP Commercial |
$521.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.77
|
| Rate for Payer: Priority Health SBD |
$386.79
|
| Rate for Payer: UMR Bronson Commercial |
$270.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.47
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
OP
|
$613.96
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$227.17 |
| Max. Negotiated Rate |
$2,925.66 |
| Rate for Payer: Aetna American Axle |
$399.07
|
| Rate for Payer: Aetna Commercial |
$521.87
|
| Rate for Payer: Aetna Medicare |
$966.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,161.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,161.70
|
| Rate for Payer: BCBS Complete |
$533.82
|
| Rate for Payer: BCBS MAPPO |
$929.36
|
| Rate for Payer: BCBS Trust/PPO |
$792.58
|
| Rate for Payer: BCN Medicare Advantage |
$929.36
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cofinity Commercial |
$429.77
|
| Rate for Payer: Cofinity Commercial |
$528.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.36
|
| Rate for Payer: Healthscope Commercial |
$552.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$429.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.47
|
| Rate for Payer: Mclaren Medicaid |
$508.36
|
| Rate for Payer: Mclaren Medicare |
$929.36
|
| Rate for Payer: Meridian Medicaid |
$533.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$975.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,068.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.87
|
| Rate for Payer: PACE Medicare |
$882.89
|
| Rate for Payer: PACE SWMI |
$929.36
|
| Rate for Payer: PHP Commercial |
$521.87
|
| Rate for Payer: PHP Medicare Advantage |
$929.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,925.66
|
| Rate for Payer: Priority Health Medicare |
$929.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,340.53
|
| Rate for Payer: Priority Health SBD |
$386.79
|
| Rate for Payer: Railroad Medicare Medicare |
$929.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.05
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$929.36
|
| Rate for Payer: UHC Exchange |
$236.41
|
| Rate for Payer: UHC Medicare Advantage |
$957.24
|
| Rate for Payer: UMR Bronson Commercial |
$227.17
|
| Rate for Payer: VA VA |
$929.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.47
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.95
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCBS Trust/PPO |
$11.48
|
| Rate for Payer: BCN Medicare Advantage |
$12.76
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.76
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$12.76
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$12.12
|
| Rate for Payer: PACE SWMI |
$12.76
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.00
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health Narrow Network |
$12.80
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$12.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.31
|
| Rate for Payer: UHC Core |
$21.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.76
|
| Rate for Payer: UHC Exchange |
$12.76
|
| Rate for Payer: UHC Medicare Advantage |
$13.14
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$12.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC TRANSFUSION
|
Facility
|
IP
|
$1,173.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$516.12 |
| Max. Negotiated Rate |
$1,055.70 |
| Rate for Payer: Aetna American Axle |
$762.45
|
| Rate for Payer: Aetna Commercial |
$997.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.45
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cofinity Commercial |
$1,008.78
|
| Rate for Payer: Cofinity Commercial |
$821.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$938.40
|
| Rate for Payer: Healthscope Commercial |
$1,055.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$821.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$879.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.05
|
| Rate for Payer: PHP Commercial |
$997.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.10
|
| Rate for Payer: Priority Health SBD |
$738.99
|
| Rate for Payer: UMR Bronson Commercial |
$516.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$879.75
|
|
|
HC TRANSFUSION
|
Facility
|
OP
|
$1,173.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$41.59 |
| Max. Negotiated Rate |
$1,214.73 |
| Rate for Payer: Aetna American Axle |
$762.45
|
| Rate for Payer: Aetna Commercial |
$997.05
|
| Rate for Payer: Aetna Medicare |
$401.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.34
|
| Rate for Payer: BCBS Complete |
$221.64
|
| Rate for Payer: BCBS MAPPO |
$385.87
|
| Rate for Payer: BCBS Trust/PPO |
$192.68
|
| Rate for Payer: BCN Medicare Advantage |
$385.87
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cofinity Commercial |
$821.10
|
| Rate for Payer: Cofinity Commercial |
$1,008.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$938.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.87
|
| Rate for Payer: Healthscope Commercial |
$1,055.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$821.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$879.75
|
| Rate for Payer: Mclaren Medicaid |
$211.07
|
| Rate for Payer: Mclaren Medicare |
$385.87
|
| Rate for Payer: Meridian Medicaid |
$221.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$405.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.05
|
| Rate for Payer: PACE Medicare |
$366.58
|
| Rate for Payer: PACE SWMI |
$385.87
|
| Rate for Payer: PHP Commercial |
$997.05
|
| Rate for Payer: PHP Medicare Advantage |
$385.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,214.73
|
| Rate for Payer: Priority Health Medicare |
$385.87
|
| Rate for Payer: Priority Health Narrow Network |
$971.78
|
| Rate for Payer: Priority Health SBD |
$738.99
|
| Rate for Payer: Railroad Medicare Medicare |
$385.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.75
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.87
|
| Rate for Payer: UHC Exchange |
$41.59
|
| Rate for Payer: UHC Medicare Advantage |
$397.45
|
| Rate for Payer: UMR Bronson Commercial |
$434.01
|
| Rate for Payer: VA VA |
$385.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$879.75
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$619.65
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.07 |
| Max. Negotiated Rate |
$1,214.73 |
| Rate for Payer: Aetna American Axle |
$402.77
|
| Rate for Payer: Aetna Commercial |
$526.70
|
| Rate for Payer: Aetna Medicare |
$401.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.34
|
| Rate for Payer: BCBS Complete |
$221.64
|
| Rate for Payer: BCBS MAPPO |
$385.87
|
| Rate for Payer: BCBS Trust/PPO |
$427.29
|
| Rate for Payer: BCN Medicare Advantage |
$385.87
|
| Rate for Payer: Cash Price |
$495.72
|
| Rate for Payer: Cash Price |
$495.72
|
| Rate for Payer: Cofinity Commercial |
$433.76
|
| Rate for Payer: Cofinity Commercial |
$532.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.87
|
| Rate for Payer: Healthscope Commercial |
$557.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$433.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.74
|
| Rate for Payer: Mclaren Medicaid |
$211.07
|
| Rate for Payer: Mclaren Medicare |
$385.87
|
| Rate for Payer: Meridian Medicaid |
$221.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$405.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.70
|
| Rate for Payer: PACE Medicare |
$366.58
|
| Rate for Payer: PACE SWMI |
$385.87
|
| Rate for Payer: PHP Commercial |
$526.70
|
| Rate for Payer: PHP Medicare Advantage |
$385.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,214.73
|
| Rate for Payer: Priority Health Medicare |
$385.87
|
| Rate for Payer: Priority Health Narrow Network |
$971.78
|
| Rate for Payer: Priority Health SBD |
$390.38
|
| Rate for Payer: Railroad Medicare Medicare |
$385.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.83
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.87
|
| Rate for Payer: UHC Exchange |
$335.30
|
| Rate for Payer: UHC Medicare Advantage |
$397.45
|
| Rate for Payer: UMR Bronson Commercial |
$229.27
|
| Rate for Payer: VA VA |
$385.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.74
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
IP
|
$619.65
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$272.65 |
| Max. Negotiated Rate |
$557.68 |
| Rate for Payer: Aetna American Axle |
$402.77
|
| Rate for Payer: Aetna Commercial |
$526.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.77
|
| Rate for Payer: Cash Price |
$495.72
|
| Rate for Payer: Cofinity Commercial |
$532.90
|
| Rate for Payer: Cofinity Commercial |
$433.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.72
|
| Rate for Payer: Healthscope Commercial |
$557.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$433.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.70
|
| Rate for Payer: PHP Commercial |
$526.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.76
|
| Rate for Payer: Priority Health SBD |
$390.38
|
| Rate for Payer: UMR Bronson Commercial |
$272.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.74
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,106.01
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.91 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,018.91
|
| Rate for Payer: Aetna Commercial |
$2,640.11
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,018.91
|
| 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 |
$139.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cofinity Commercial |
$2,671.17
|
| Rate for Payer: Cofinity Commercial |
$2,174.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,484.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,795.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,174.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,329.51
|
| 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 |
$2,640.11
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,640.11
|
| 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 |
$2,174.21
|
| 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 |
$1,956.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.40
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$134.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,149.22
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,329.51
|
|
