|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
IP
|
$2,205.59
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$970.46 |
| Max. Negotiated Rate |
$1,985.03 |
| Rate for Payer: Aetna American Axle |
$1,433.63
|
| Rate for Payer: Aetna Commercial |
$1,874.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.63
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cofinity Commercial |
$1,543.91
|
| Rate for Payer: Cofinity Commercial |
$1,896.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,543.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.47
|
| Rate for Payer: Healthscope Commercial |
$1,985.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,543.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: PHP Commercial |
$1,874.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: Priority Health SBD |
$1,389.52
|
| Rate for Payer: UMR Bronson Commercial |
$970.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.19
|
|
|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
OP
|
$2,205.59
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$1,433.63
|
| Rate for Payer: Aetna Commercial |
$1,874.75
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cofinity Commercial |
$1,896.81
|
| Rate for Payer: Cofinity Commercial |
$1,543.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,543.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$1,985.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,543.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.19
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,874.75
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$1,389.52
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$816.07
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.19
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UMR Bronson Commercial |
$149.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$125.93 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$170.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: BCBS Complete |
$136.14
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
IP
|
$261.34
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$114.99 |
| Max. Negotiated Rate |
$235.21 |
| Rate for Payer: Aetna American Axle |
$169.87
|
| Rate for Payer: Aetna Commercial |
$222.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.87
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cofinity Commercial |
$182.94
|
| Rate for Payer: Cofinity Commercial |
$224.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.07
|
| Rate for Payer: Healthscope Commercial |
$235.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.14
|
| Rate for Payer: PHP Commercial |
$222.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.87
|
| Rate for Payer: Priority Health SBD |
$164.64
|
| Rate for Payer: UMR Bronson Commercial |
$114.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.00
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
OP
|
$261.34
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$169.87
|
| Rate for Payer: Aetna Commercial |
$222.14
|
| Rate for Payer: Aetna Medicare |
$130.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.87
|
| Rate for Payer: BCBS Complete |
$104.54
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cofinity Commercial |
$224.75
|
| Rate for Payer: Cofinity Commercial |
$182.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.07
|
| Rate for Payer: Healthscope Commercial |
$235.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.14
|
| Rate for Payer: PHP Commercial |
$222.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.87
|
| Rate for Payer: Priority Health SBD |
$164.64
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$96.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.00
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$143.82 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$194.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$143.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$171.03 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UMR Bronson Commercial |
$171.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC IR GUIDEWIRE
|
Facility
|
IP
|
$44.74
|
|
| Hospital Charge Code |
27200306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna American Axle |
$29.08
|
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.08
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$31.32
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health SBD |
$28.19
|
| Rate for Payer: UMR Bronson Commercial |
$19.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC IR GUIDEWIRE
|
Facility
|
OP
|
$44.74
|
|
| Hospital Charge Code |
27200306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna American Axle |
$29.08
|
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.08
|
| Rate for Payer: BCBS Complete |
$17.90
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$31.32
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health SBD |
$28.19
|
| Rate for Payer: UMR Bronson Commercial |
$16.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.84 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: UMR Bronson Commercial |
$213.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.82 |
| Max. Negotiated Rate |
$980.43 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$179.82
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
OP
|
$825.69
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$536.70
|
| Rate for Payer: Aetna Commercial |
$701.84
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cofinity Commercial |
$710.09
|
| Rate for Payer: Cofinity Commercial |
$577.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$743.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.27
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$701.84
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$520.18
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$305.51
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.27
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
IP
|
$825.69
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$363.30 |
| Max. Negotiated Rate |
$743.12 |
| Rate for Payer: Aetna American Axle |
$536.70
|
| Rate for Payer: Aetna Commercial |
$701.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.70
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cofinity Commercial |
$577.98
|
| Rate for Payer: Cofinity Commercial |
$710.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.55
|
| Rate for Payer: Healthscope Commercial |
$743.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: PHP Commercial |
$701.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: Priority Health SBD |
$520.18
|
| Rate for Payer: UMR Bronson Commercial |
$363.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.27
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
OP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$1,272.70
|
| Rate for Payer: Aetna Commercial |
$1,664.30
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,683.88
|
| Rate for Payer: Cofinity Commercial |
$1,370.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,370.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$1,762.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,370.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,468.50
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$1,664.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,233.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: UMR Bronson Commercial |
$724.46
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,468.50
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
IP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$861.52 |
| Max. Negotiated Rate |
$1,762.20 |
| Rate for Payer: Aetna American Axle |
$1,272.70
|
| Rate for Payer: Aetna Commercial |
$1,664.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.70
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,370.60
|
| Rate for Payer: Cofinity Commercial |
$1,683.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,370.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.40
|
| Rate for Payer: Healthscope Commercial |
$1,762.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,370.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,468.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: PHP Commercial |
$1,664.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health SBD |
$1,233.54
|
| Rate for Payer: UMR Bronson Commercial |
$861.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,468.50
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
OP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,797.53
|
| Rate for Payer: Aetna Commercial |
$3,658.31
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,797.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cofinity Commercial |
$3,701.35
|
| Rate for Payer: Cofinity Commercial |
$3,012.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,012.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,443.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,873.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,012.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,227.92
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,658.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,711.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,592.44
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,227.92
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
IP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,893.71 |
| Max. Negotiated Rate |
$3,873.50 |
| Rate for Payer: Aetna American Axle |
$2,797.53
|
| Rate for Payer: Aetna Commercial |
$3,658.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,797.53
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cofinity Commercial |
$3,012.72
|
| Rate for Payer: Cofinity Commercial |
$3,701.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,012.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,443.11
|
| Rate for Payer: Healthscope Commercial |
$3,873.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,012.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,227.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: PHP Commercial |
$3,658.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: Priority Health SBD |
$2,711.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,893.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,227.92
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
OP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,255.73
|
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,255.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$2,984.51
|
| Rate for Payer: Cofinity Commercial |
$2,429.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,429.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,123.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,429.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,602.77
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,186.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,284.03
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,602.77
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
IP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,526.96 |
| Max. Negotiated Rate |
$3,123.32 |
| Rate for Payer: Aetna American Axle |
$2,255.73
|
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,255.73
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$2,429.25
|
| Rate for Payer: Cofinity Commercial |
$2,984.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,429.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Healthscope Commercial |
$3,123.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,429.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,602.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health SBD |
$2,186.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,526.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,602.77
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
OP
|
$1,268.04
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$2,444.12 |
| Rate for Payer: Aetna American Axle |
$824.23
|
| Rate for Payer: Aetna Commercial |
$1,077.83
|
| Rate for Payer: Aetna Medicare |
$903.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cofinity Commercial |
$887.63
|
| Rate for Payer: Cofinity Commercial |
$1,090.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$887.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,141.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$887.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.03
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$1,077.83
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.23
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health SBD |
$798.87
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,444.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,659.37
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: UMR Bronson Commercial |
$469.17
|
| Rate for Payer: VA VA |
$868.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.03
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
IP
|
$1,268.04
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$557.94 |
| Max. Negotiated Rate |
$1,141.24 |
| Rate for Payer: Aetna American Axle |
$824.23
|
| Rate for Payer: Aetna Commercial |
$1,077.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.23
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cofinity Commercial |
$1,090.51
|
| Rate for Payer: Cofinity Commercial |
$887.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$887.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.43
|
| Rate for Payer: Healthscope Commercial |
$1,141.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$887.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: PHP Commercial |
$1,077.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.23
|
| Rate for Payer: Priority Health SBD |
$798.87
|
| Rate for Payer: UMR Bronson Commercial |
$557.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.03
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
IP
|
$1,650.89
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$726.39 |
| Max. Negotiated Rate |
$1,485.80 |
| Rate for Payer: Aetna American Axle |
$1,073.08
|
| Rate for Payer: Aetna Commercial |
$1,403.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.08
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cofinity Commercial |
$1,155.62
|
| Rate for Payer: Cofinity Commercial |
$1,419.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,155.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.71
|
| Rate for Payer: Healthscope Commercial |
$1,485.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,155.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,238.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.26
|
| Rate for Payer: PHP Commercial |
$1,403.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.08
|
| Rate for Payer: Priority Health SBD |
$1,040.06
|
| Rate for Payer: UMR Bronson Commercial |
$726.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,238.17
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
OP
|
$1,650.89
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$2,444.12 |
| Rate for Payer: Aetna American Axle |
$1,073.08
|
| Rate for Payer: Aetna Commercial |
$1,403.26
|
| Rate for Payer: Aetna Medicare |
$903.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,073.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cofinity Commercial |
$1,419.77
|
| Rate for Payer: Cofinity Commercial |
$1,155.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,155.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,485.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,155.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,238.17
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.26
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$1,403.26
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.08
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health SBD |
$1,040.06
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,444.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,659.37
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: UMR Bronson Commercial |
$610.83
|
| Rate for Payer: VA VA |
$868.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,238.17
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,132.19 |
| Max. Negotiated Rate |
$4,361.30 |
| Rate for Payer: Aetna American Axle |
$3,149.83
|
| Rate for Payer: Aetna Commercial |
$4,119.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,149.83
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cofinity Commercial |
$3,392.12
|
| Rate for Payer: Cofinity Commercial |
$4,167.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,392.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,876.71
|
| Rate for Payer: Healthscope Commercial |
$4,361.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,392.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,634.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: PHP Commercial |
$4,119.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: Priority Health SBD |
$3,052.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,132.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,634.42
|
|
