|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
OP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,792.98 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna American Axle |
$3,149.83
|
| Rate for Payer: Aetna Commercial |
$4,119.01
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,149.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cofinity Commercial |
$4,167.47
|
| Rate for Payer: Cofinity Commercial |
$3,392.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,392.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,876.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| 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: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$4,119.01
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$3,052.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$6,577.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,792.98
|
| Rate for Payer: VA VA |
$3,441.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,634.42
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,138.79 |
| Max. Negotiated Rate |
$4,374.79 |
| Rate for Payer: Aetna American Axle |
$3,159.57
|
| Rate for Payer: Aetna Commercial |
$4,131.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,159.57
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$3,402.62
|
| Rate for Payer: Cofinity Commercial |
$4,180.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,402.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Healthscope Commercial |
$4,374.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,402.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,645.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,131.75
|
| Rate for Payer: PHP Commercial |
$4,131.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.57
|
| Rate for Payer: Priority Health SBD |
$3,062.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,138.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,645.66
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$3,159.57
|
| Rate for Payer: Aetna Commercial |
$4,131.75
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,159.57
|
| 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 |
$3,888.70
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,180.36
|
| Rate for Payer: Cofinity Commercial |
$3,402.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,402.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,374.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,402.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,645.66
|
| 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 |
$4,131.75
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$4,131.75
|
| 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 |
$3,159.57
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$3,062.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| 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 |
$1,798.53
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,645.66
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,012.48 |
| Max. Negotiated Rate |
$4,116.44 |
| Rate for Payer: Aetna American Axle |
$2,972.98
|
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.98
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,201.67
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,201.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,201.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,430.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health SBD |
$2,881.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,012.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,430.36
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,972.98
|
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.98
|
| 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 |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Cofinity Commercial |
$3,201.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,201.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,201.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,430.36
|
| 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 |
$3,887.75
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| 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 |
$2,972.98
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,881.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| 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 |
$1,692.31
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,430.36
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,141.00 |
| Max. Negotiated Rate |
$4,379.33 |
| Rate for Payer: Aetna American Axle |
$3,162.85
|
| Rate for Payer: Aetna Commercial |
$4,136.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,162.85
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$3,406.14
|
| Rate for Payer: Cofinity Commercial |
$4,184.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,406.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Healthscope Commercial |
$4,379.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,406.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,649.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: PHP Commercial |
$4,136.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: Priority Health SBD |
$3,065.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,141.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,649.44
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,800.39 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$3,162.85
|
| Rate for Payer: Aetna Commercial |
$4,136.03
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,162.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,184.69
|
| Rate for Payer: Cofinity Commercial |
$3,406.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,406.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$4,379.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,406.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,649.44
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$4,136.03
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$3,065.53
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,800.39
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,649.44
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$869.32 |
| Max. Negotiated Rate |
$1,778.15 |
| Rate for Payer: Aetna American Axle |
$1,284.22
|
| Rate for Payer: Aetna Commercial |
$1,679.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.22
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,383.00
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,383.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Healthscope Commercial |
$1,778.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,383.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: PHP Commercial |
$1,679.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: Priority Health SBD |
$1,244.70
|
| Rate for Payer: UMR Bronson Commercial |
$869.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.79
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$1,284.22
|
| Rate for Payer: Aetna Commercial |
$1,679.36
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.22
|
| 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 |
$1,580.58
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Cofinity Commercial |
$1,383.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,383.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,778.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,383.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.79
|
| 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 |
$1,679.36
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$1,679.36
|
| 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 |
$1,284.22
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,244.70
|
| 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 |
$731.02
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.79
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$1,681.82
|
| Rate for Payer: Aetna Commercial |
$2,199.30
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,681.82
|
| 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 |
$2,069.93
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,225.17
|
| Rate for Payer: Cofinity Commercial |
$1,811.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,811.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,328.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,811.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,940.56
|
| 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 |
$2,199.30
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,199.30
|
| 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 |
$1,681.82
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,630.07
|
| 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 |
$957.34
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,940.56
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,138.46 |
| Max. Negotiated Rate |
$2,328.67 |
| Rate for Payer: Aetna American Axle |
$1,681.82
|
| Rate for Payer: Aetna Commercial |
$2,199.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,681.82
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$1,811.19
|
| Rate for Payer: Cofinity Commercial |
$2,225.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,811.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Healthscope Commercial |
$2,328.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,811.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,940.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: PHP Commercial |
$2,199.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: Priority Health SBD |
$1,630.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,138.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,940.56
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.85 |
| Max. Negotiated Rate |
$1,253.55 |
| Rate for Payer: Aetna American Axle |
$905.34
|
| Rate for Payer: Aetna Commercial |
$1,183.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.34
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,197.83
|
| Rate for Payer: Cofinity Commercial |
$974.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$974.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Healthscope Commercial |
$1,253.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$974.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: PHP Commercial |
$1,183.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: Priority Health SBD |
$877.48
|
| Rate for Payer: UMR Bronson Commercial |
$612.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.62
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$905.34
|
| Rate for Payer: Aetna Commercial |
$1,183.91
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$905.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$974.98
|
| Rate for Payer: Cofinity Commercial |
$1,197.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$974.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,253.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$974.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.62
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$1,183.91
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$877.48
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$515.35
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.62
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.56 |
| Max. Negotiated Rate |
$956.37 |
| Rate for Payer: Aetna American Axle |
$690.71
|
| Rate for Payer: Aetna Commercial |
$903.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$690.71
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$743.84
|
| Rate for Payer: Cofinity Commercial |
$913.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$743.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Healthscope Commercial |
$956.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$743.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$796.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: PHP Commercial |
$903.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: Priority Health SBD |
$669.46
|
| Rate for Payer: UMR Bronson Commercial |
$467.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$796.97
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$690.71
|
| Rate for Payer: Aetna Commercial |
$903.24
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$690.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$913.86
|
| Rate for Payer: Cofinity Commercial |
$743.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$743.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$956.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$743.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$796.97
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$903.24
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$669.46
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$393.17
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$796.97
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$1,968.32
|
| Rate for Payer: Aetna Commercial |
$2,573.96
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,968.32
|
| 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 |
$2,422.55
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,604.24
|
| Rate for Payer: Cofinity Commercial |
$2,119.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,119.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,725.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,119.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,271.14
|
| 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 |
$2,573.96
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,573.96
|
| 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 |
$1,968.32
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,907.76
|
| 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 |
$1,120.43
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,271.14
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,332.40 |
| Max. Negotiated Rate |
$2,725.37 |
| Rate for Payer: Aetna American Axle |
$1,968.32
|
| Rate for Payer: Aetna Commercial |
$2,573.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,968.32
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,119.73
|
| Rate for Payer: Cofinity Commercial |
$2,604.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,119.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Healthscope Commercial |
$2,725.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,119.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,271.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: PHP Commercial |
$2,573.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: Priority Health SBD |
$1,907.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,332.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,271.14
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$844.74
|
| Rate for Payer: Aetna Commercial |
$1,104.66
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.74
|
| 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 |
$1,039.68
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$909.72
|
| Rate for Payer: Cofinity Commercial |
$1,117.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$909.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,169.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$909.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.70
|
| 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 |
$1,104.66
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$1,104.66
|
| 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 |
$844.74
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$818.75
|
| 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 |
$480.85
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.70
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$571.82 |
| Max. Negotiated Rate |
$1,169.64 |
| Rate for Payer: Aetna American Axle |
$844.74
|
| Rate for Payer: Aetna Commercial |
$1,104.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.74
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,117.66
|
| Rate for Payer: Cofinity Commercial |
$909.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$909.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Healthscope Commercial |
$1,169.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$909.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: PHP Commercial |
$1,104.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: Priority Health SBD |
$818.75
|
| Rate for Payer: UMR Bronson Commercial |
$571.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.70
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.81 |
| Max. Negotiated Rate |
$1,200.19 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$443.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$532.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$532.96
|
| Rate for Payer: BCBS Complete |
$239.96
|
| Rate for Payer: BCBS MAPPO |
$426.37
|
| Rate for Payer: BCN Medicare Advantage |
$426.37
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.37
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$228.53
|
| Rate for Payer: Mclaren Medicare |
$426.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.69
|
| Rate for Payer: Meridian Medicaid |
$239.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$490.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PACE Medicare |
$405.05
|
| Rate for Payer: PACE SWMI |
$426.37
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$426.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health Medicare |
$426.37
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: Railroad Medicare Medicare |
$426.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.37
|
| Rate for Payer: UHC Exchange |
$814.84
|
| Rate for Payer: UHC Medicare Advantage |
$426.37
|
| Rate for Payer: UHCCP Medicaid |
$228.53
|
| Rate for Payer: UMR Bronson Commercial |
$215.81
|
| Rate for Payer: VA VA |
$426.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.64 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: UMR Bronson Commercial |
$256.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$2,388.40
|
| Rate for Payer: Aetna Commercial |
$3,123.29
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,388.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,160.04
|
| Rate for Payer: Cofinity Commercial |
$2,572.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,572.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,307.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,572.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,755.84
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,123.29
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,314.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,359.55
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,755.84
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,616.76 |
| Max. Negotiated Rate |
$3,307.01 |
| Rate for Payer: Aetna American Axle |
$2,388.40
|
| Rate for Payer: Aetna Commercial |
$3,123.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,388.40
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$2,572.12
|
| Rate for Payer: Cofinity Commercial |
$3,160.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,572.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Healthscope Commercial |
$3,307.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,572.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,755.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: PHP Commercial |
$3,123.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: Priority Health SBD |
$2,314.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,616.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,755.84
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$597.16
|
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Cofinity Commercial |
$643.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$578.79
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,472.56
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UMR Bronson Commercial |
$339.92
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$404.23 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna American Axle |
$597.16
|
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.16
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$643.10
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health SBD |
$578.79
|
| Rate for Payer: UMR Bronson Commercial |
$404.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
