|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$15.53
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.76
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$14.21
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Core |
$21.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: UMR Bronson Commercial |
$24.53
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: BCBS Complete |
$9.65
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$15.11
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$9.19
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Medicaid |
$9.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.05
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health Narrow Network |
$18.44
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.16
|
| Rate for Payer: UHC Core |
$27.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.80
|
| Rate for Payer: UHC Exchange |
$16.80
|
| Rate for Payer: UHC Medicare Advantage |
$17.30
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$16.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$173.36 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Aetna American Axle |
$256.10
|
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$334.90
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.80
|
| Rate for Payer: Priority Health SBD |
$248.22
|
| Rate for Payer: UMR Bronson Commercial |
$173.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.50
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.43 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$256.10
|
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$229.78
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.50
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$334.90
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$248.22
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$50.43
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$145.78
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.50
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
IP
|
$2,033.83
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$894.89 |
| Max. Negotiated Rate |
$1,830.45 |
| Rate for Payer: Aetna American Axle |
$1,321.99
|
| Rate for Payer: Aetna Commercial |
$1,728.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,321.99
|
| Rate for Payer: Cash Price |
$1,627.06
|
| Rate for Payer: Cofinity Commercial |
$1,423.68
|
| Rate for Payer: Cofinity Commercial |
$1,749.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,627.06
|
| Rate for Payer: Healthscope Commercial |
$1,830.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,423.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,525.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,728.76
|
| Rate for Payer: PHP Commercial |
$1,728.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.68
|
| Rate for Payer: Priority Health SBD |
$1,281.31
|
| Rate for Payer: UMR Bronson Commercial |
$894.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,525.37
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
OP
|
$2,033.83
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$75.64 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,321.99
|
| Rate for Payer: Aetna Commercial |
$1,728.76
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,321.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,295.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$1,627.06
|
| Rate for Payer: Cash Price |
$1,627.06
|
| Rate for Payer: Cofinity Commercial |
$1,423.68
|
| Rate for Payer: Cofinity Commercial |
$1,749.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,627.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$1,830.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,423.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,525.37
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,728.76
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,728.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,281.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.20
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$75.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$752.52
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,525.37
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
IP
|
$214.77
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$193.29 |
| Rate for Payer: Aetna American Axle |
$139.60
|
| Rate for Payer: Aetna Commercial |
$182.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.60
|
| Rate for Payer: Cash Price |
$171.82
|
| Rate for Payer: Cofinity Commercial |
$150.34
|
| Rate for Payer: Cofinity Commercial |
$184.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.82
|
| Rate for Payer: Healthscope Commercial |
$193.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.55
|
| Rate for Payer: PHP Commercial |
$182.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.34
|
| Rate for Payer: Priority Health SBD |
$135.31
|
| Rate for Payer: UMR Bronson Commercial |
$94.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.08
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
OP
|
$214.77
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$29.14 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$139.60
|
| Rate for Payer: Aetna Commercial |
$182.55
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.60
|
| 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 |
$280.01
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$171.82
|
| Rate for Payer: Cash Price |
$171.82
|
| Rate for Payer: Cofinity Commercial |
$150.34
|
| Rate for Payer: Cofinity Commercial |
$184.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$193.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.08
|
| 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 |
$182.55
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$182.55
|
| 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 |
$150.34
|
| 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 |
$135.31
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.05
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$29.14
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$79.46
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.08
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
OP
|
$471.44
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.64 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$306.44
|
| Rate for Payer: Aetna Commercial |
$400.72
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$403.77
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$377.15
|
| Rate for Payer: Cash Price |
$377.15
|
| Rate for Payer: Cofinity Commercial |
$405.44
|
| Rate for Payer: Cofinity Commercial |
$330.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$424.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.58
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$400.72
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$400.72
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.93
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$891.94
|
| Rate for Payer: Priority Health SBD |
$297.01
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.50
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Exchange |
$38.64
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$174.43
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.58
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
IP
|
$471.44
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$207.43 |
| Max. Negotiated Rate |
$424.30 |
| Rate for Payer: Aetna American Axle |
$306.44
|
| Rate for Payer: Aetna Commercial |
$400.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.44
|
| Rate for Payer: Cash Price |
$377.15
|
| Rate for Payer: Cofinity Commercial |
$330.01
|
| Rate for Payer: Cofinity Commercial |
$405.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.15
|
| Rate for Payer: Healthscope Commercial |
$424.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$400.72
|
| Rate for Payer: PHP Commercial |
$400.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.01
|
| Rate for Payer: Priority Health SBD |
$297.01
|
| Rate for Payer: UMR Bronson Commercial |
$207.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.58
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
IP
|
$303.31
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$133.46 |
| Max. Negotiated Rate |
$272.98 |
| Rate for Payer: Aetna American Axle |
$197.15
|
| Rate for Payer: Aetna Commercial |
$257.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.15
|
| Rate for Payer: Cash Price |
$242.65
|
| Rate for Payer: Cofinity Commercial |
$212.32
|
| Rate for Payer: Cofinity Commercial |
$260.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.65
|
| Rate for Payer: Healthscope Commercial |
$272.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.81
|
| Rate for Payer: PHP Commercial |
$257.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.32
|
| Rate for Payer: Priority Health SBD |
$191.09
|
| Rate for Payer: UMR Bronson Commercial |
$133.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.48
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
OP
|
$303.31
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.22 |
| Max. Negotiated Rate |
$272.98 |
| Rate for Payer: Aetna American Axle |
$197.15
|
| Rate for Payer: Aetna Commercial |
$257.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.15
|
| Rate for Payer: BCBS Complete |
$121.32
|
| Rate for Payer: Cash Price |
$242.65
|
| Rate for Payer: Cofinity Commercial |
$212.32
|
| Rate for Payer: Cofinity Commercial |
$260.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.65
|
| Rate for Payer: Healthscope Commercial |
$272.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.81
|
| Rate for Payer: PHP Commercial |
$257.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.32
|
| Rate for Payer: Priority Health SBD |
$191.09
|
| Rate for Payer: UMR Bronson Commercial |
$112.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.48
|
|
|
HC TUBING 1/2
|
Facility
|
OP
|
$18.00
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Aetna American Axle |
$11.70
|
| Rate for Payer: Aetna Commercial |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.70
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$12.60
|
| Rate for Payer: Cofinity Commercial |
$15.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.40
|
| Rate for Payer: Healthscope Commercial |
$16.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.30
|
| Rate for Payer: PHP Commercial |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health SBD |
$11.34
|
| Rate for Payer: UMR Bronson Commercial |
$6.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.50
|
|
|
HC TUBING 1/2
|
Facility
|
IP
|
$18.00
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Aetna American Axle |
$11.70
|
| Rate for Payer: Aetna Commercial |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.70
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$12.60
|
| Rate for Payer: Cofinity Commercial |
$15.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.40
|
| Rate for Payer: Healthscope Commercial |
$16.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.30
|
| Rate for Payer: PHP Commercial |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health SBD |
$11.34
|
| Rate for Payer: UMR Bronson Commercial |
$7.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.50
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna American Axle |
$15.60
|
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.60
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health SBD |
$15.12
|
| Rate for Payer: UMR Bronson Commercial |
$10.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.88 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna American Axle |
$15.60
|
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.60
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health SBD |
$15.12
|
| Rate for Payer: UMR Bronson Commercial |
$8.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$28.50
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Aetna American Axle |
$18.52
|
| Rate for Payer: Aetna Commercial |
$24.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.52
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Cofinity Commercial |
$24.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.80
|
| Rate for Payer: Healthscope Commercial |
$25.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.22
|
| Rate for Payer: PHP Commercial |
$24.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.95
|
| Rate for Payer: Priority Health SBD |
$17.96
|
| Rate for Payer: UMR Bronson Commercial |
$10.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.38
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$28.50
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.54 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Aetna American Axle |
$18.52
|
| Rate for Payer: Aetna Commercial |
$24.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.52
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Cofinity Commercial |
$24.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.80
|
| Rate for Payer: Healthscope Commercial |
$25.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.22
|
| Rate for Payer: PHP Commercial |
$24.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.95
|
| Rate for Payer: Priority Health SBD |
$17.96
|
| Rate for Payer: UMR Bronson Commercial |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.38
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$198.39
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$45.72 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$128.95
|
| Rate for Payer: Aetna Commercial |
$168.63
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$109.75
|
| Rate for Payer: BCCCP Commercial |
$119.02
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cofinity Commercial |
$138.87
|
| Rate for Payer: Cofinity Commercial |
$170.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$178.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.79
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.63
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$124.99
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.03
|
| Rate for Payer: UHC Core |
$45.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Exchange |
$118.21
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$73.40
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.79
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$198.39
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$87.29 |
| Max. Negotiated Rate |
$178.55 |
| Rate for Payer: Aetna American Axle |
$128.95
|
| Rate for Payer: Aetna Commercial |
$168.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.95
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cofinity Commercial |
$138.87
|
| Rate for Payer: Cofinity Commercial |
$170.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.71
|
| Rate for Payer: Healthscope Commercial |
$178.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.63
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health SBD |
$124.99
|
| Rate for Payer: UMR Bronson Commercial |
$87.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.79
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,086.47
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,798.05 |
| Max. Negotiated Rate |
$3,677.82 |
| Rate for Payer: Aetna American Axle |
$2,656.21
|
| Rate for Payer: Aetna Commercial |
$3,473.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,656.21
|
| Rate for Payer: Cash Price |
$3,269.18
|
| Rate for Payer: Cofinity Commercial |
$2,860.53
|
| Rate for Payer: Cofinity Commercial |
$3,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,269.18
|
| Rate for Payer: Healthscope Commercial |
$3,677.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,860.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,064.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,473.50
|
| Rate for Payer: PHP Commercial |
$3,473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.53
|
| Rate for Payer: Priority Health SBD |
$2,574.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,798.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,064.85
|
|
|
HC TVT DEVICE KIT
|
Facility
|
OP
|
$4,086.47
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,511.99 |
| Max. Negotiated Rate |
$3,677.82 |
| Rate for Payer: Aetna American Axle |
$2,656.21
|
| Rate for Payer: Aetna Commercial |
$3,473.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,656.21
|
| Rate for Payer: BCBS Complete |
$1,634.59
|
| Rate for Payer: Cash Price |
$3,269.18
|
| Rate for Payer: Cofinity Commercial |
$2,860.53
|
| Rate for Payer: Cofinity Commercial |
$3,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,269.18
|
| Rate for Payer: Healthscope Commercial |
$3,677.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,860.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,064.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,473.50
|
| Rate for Payer: PHP Commercial |
$3,473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.53
|
| Rate for Payer: Priority Health SBD |
$2,574.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,511.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,064.85
|
|
