|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$975.38
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$429.17 |
| Max. Negotiated Rate |
$877.84 |
| Rate for Payer: Aetna American Axle |
$634.00
|
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.00
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$682.77
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$682.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$682.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health SBD |
$614.49
|
| Rate for Payer: UMR Bronson Commercial |
$429.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.54
|
|
|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$975.38
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.71 |
| Max. Negotiated Rate |
$2,132.58 |
| Rate for Payer: Cofinity Medicare Advantage |
$682.77
|
| Rate for Payer: Aetna American Axle |
$634.00
|
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: Aetna Medicare |
$705.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.15
|
| Rate for Payer: BCBS Complete |
$381.87
|
| Rate for Payer: BCBS MAPPO |
$678.52
|
| Rate for Payer: BCN Medicare Advantage |
$678.52
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Cofinity Commercial |
$682.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.52
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$682.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.54
|
| Rate for Payer: Mclaren Medicaid |
$363.69
|
| Rate for Payer: Mclaren Medicare |
$678.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.45
|
| Rate for Payer: Meridian Medicaid |
$381.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: Nomi Health Commercial |
$1,424.89
|
| Rate for Payer: PACE Medicare |
$644.59
|
| Rate for Payer: PACE SWMI |
$678.52
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$678.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,132.58
|
| Rate for Payer: Priority Health Medicare |
$678.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,706.06
|
| Rate for Payer: Priority Health SBD |
$614.49
|
| Rate for Payer: Railroad Medicare Medicare |
$678.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.58
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.52
|
| Rate for Payer: UHC Exchange |
$78.71
|
| Rate for Payer: UHC Medicare Advantage |
$678.52
|
| Rate for Payer: UHCCP Medicaid |
$363.69
|
| Rate for Payer: UMR Bronson Commercial |
$360.89
|
| Rate for Payer: VA VA |
$678.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.54
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
OP
|
$1,506.90
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$1,356.21 |
| Rate for Payer: Aetna American Axle |
$979.48
|
| Rate for Payer: Aetna Commercial |
$1,280.86
|
| Rate for Payer: Aetna Medicare |
$753.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.48
|
| Rate for Payer: BCBS Complete |
$602.76
|
| Rate for Payer: BCBS Trust/PPO |
$439.24
|
| Rate for Payer: BCN Commercial |
$439.24
|
| Rate for Payer: Cash Price |
$1,205.52
|
| Rate for Payer: Cash Price |
$1,205.52
|
| Rate for Payer: Cofinity Commercial |
$1,295.93
|
| Rate for Payer: Cofinity Commercial |
$1,054.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,054.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.52
|
| Rate for Payer: Healthscope Commercial |
$1,356.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,054.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.86
|
| Rate for Payer: PHP Commercial |
$1,280.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.48
|
| Rate for Payer: Priority Health SBD |
$949.35
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$557.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.18
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
IP
|
$1,506.90
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$663.04 |
| Max. Negotiated Rate |
$1,356.21 |
| Rate for Payer: Aetna American Axle |
$979.48
|
| Rate for Payer: Aetna Commercial |
$1,280.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.48
|
| Rate for Payer: Cash Price |
$1,205.52
|
| Rate for Payer: Cofinity Commercial |
$1,054.83
|
| Rate for Payer: Cofinity Commercial |
$1,295.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,054.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.52
|
| Rate for Payer: Healthscope Commercial |
$1,356.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,054.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.86
|
| Rate for Payer: PHP Commercial |
$1,280.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.48
|
| Rate for Payer: Priority Health SBD |
$949.35
|
| Rate for Payer: UMR Bronson Commercial |
$663.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.18
|
|
|
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 |
$492.37 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$1,433.63
|
| Rate for Payer: Aetna Commercial |
$1,874.75
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$653.58
|
| Rate for Payer: BCN Commercial |
$653.58
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$1,764.47
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,874.75
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$1,389.52
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,585.77
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,755.54
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$816.07
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.19
|
|
|
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: BCBS Trust/PPO |
$192.25
|
| Rate for Payer: BCN Commercial |
$192.25
|
| 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 |
$255.26
|
| 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 |
$255.26
|
|
|
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 |
$255.26
|
| 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 |
$255.26
|
|
|
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 |
$54.20 |
| 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: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCCCP Commercial |
$55.83
|
| Rate for Payer: BCN Commercial |
$58.15
|
| 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 All Payor (Choice/PPO) |
$59.62
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$54.20
|
| Rate for Payer: UMR Bronson Commercial |
$96.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.00
|
|
|
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 VISCERAL TISSUE AB
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$122.47 |
| 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 |
$194.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS Trust/PPO |
$122.47
|
| Rate for Payer: BCN Commercial |
$122.47
|
| 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 |
$33.56
|
| 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 |
$33.56
|
|
|
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 |
$33.56
|
| 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 |
$33.56
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$123.15 |
| Max. Negotiated Rate |
$1,099.76 |
| Rate for Payer: Aetna American Axle |
$315.90
|
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$230.57
|
| Rate for Payer: BCN Commercial |
$230.57
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| 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 |
$349.91
|
| 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 |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$306.18
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.46
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$123.15
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$179.82
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
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 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 |
$1,688.45 |
| Rate for Payer: Aetna American Axle |
$536.70
|
| Rate for Payer: Aetna Commercial |
$701.84
|
| Rate for Payer: Aetna Medicare |
$558.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.51
|
| Rate for Payer: BCBS Complete |
$302.34
|
| Rate for Payer: BCBS MAPPO |
$537.21
|
| Rate for Payer: BCBS Trust/PPO |
$675.22
|
| Rate for Payer: BCN Commercial |
$675.22
|
| Rate for Payer: BCN Medicare Advantage |
$537.21
|
| 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 |
$537.21
|
| 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 |
$287.94
|
| Rate for Payer: Mclaren Medicare |
$537.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.07
|
| Rate for Payer: Meridian Medicaid |
$302.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: Nomi Health Commercial |
$1,611.63
|
| Rate for Payer: PACE Medicare |
$510.35
|
| Rate for Payer: PACE SWMI |
$537.21
|
| Rate for Payer: PHP Commercial |
$701.84
|
| Rate for Payer: PHP Medicare Advantage |
$537.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,688.45
|
| Rate for Payer: Priority Health Medicare |
$537.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.76
|
| Rate for Payer: Priority Health SBD |
$520.18
|
| Rate for Payer: Railroad Medicare Medicare |
$537.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,512.19
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.21
|
| Rate for Payer: UHC Exchange |
$1,026.66
|
| Rate for Payer: UHC Medicare Advantage |
$537.21
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: UMR Bronson Commercial |
$305.51
|
| Rate for Payer: VA VA |
$537.21
|
| 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
|
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 GU URETERAL DILATATION
|
Facility
|
OP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$109.55 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$1,272.70
|
| Rate for Payer: Aetna Commercial |
$1,664.30
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$166.25
|
| Rate for Payer: BCN Commercial |
$166.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| 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 |
$2,007.09
|
| 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 |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: Nomi Health Commercial |
$6,021.27
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$1,664.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$1,233.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.50
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$109.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$724.46
|
| Rate for Payer: VA VA |
$2,007.09
|
| 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 |
$114.55 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,797.53
|
| Rate for Payer: Aetna Commercial |
$3,658.31
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,797.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$148.46
|
| Rate for Payer: BCN Commercial |
$148.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| 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 |
$3,083.86
|
| 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 |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,658.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,711.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.00
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$114.55
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,592.44
|
| Rate for Payer: VA VA |
$3,083.86
|
| 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 |
$106.63 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,255.73
|
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,255.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$126.57
|
| Rate for Payer: BCN Commercial |
$126.57
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| 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 |
$3,083.86
|
| 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 |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,186.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$106.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,284.03
|
| Rate for Payer: VA VA |
$3,083.86
|
| 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 |
$100.51 |
| Max. Negotiated Rate |
$2,741.59 |
| Rate for Payer: Aetna American Axle |
$824.23
|
| Rate for Payer: Aetna Commercial |
$1,077.83
|
| Rate for Payer: Aetna Medicare |
$907.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.15
|
| Rate for Payer: BCN Commercial |
$1,421.15
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,014.43
|
| 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 |
$872.29
|
| 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 |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: Nomi Health Commercial |
$1,831.81
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$1,077.83
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,741.59
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,193.27
|
| Rate for Payer: Priority Health SBD |
$798.87
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.56
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$100.51
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: UMR Bronson Commercial |
$469.17
|
| Rate for Payer: VA VA |
$872.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.03
|
|
