|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$658.55
|
| Rate for Payer: Aetna Commercial |
$861.18
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.55
|
| 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 |
$810.52
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$871.31
|
| Rate for Payer: Cofinity Commercial |
$709.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$709.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$911.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$709.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$759.86
|
| 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 |
$861.18
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$861.18
|
| 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 |
$658.55
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$638.28
|
| 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 |
$374.87
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$759.86
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$445.79 |
| Max. Negotiated Rate |
$911.84 |
| Rate for Payer: Aetna American Axle |
$658.55
|
| Rate for Payer: Aetna Commercial |
$861.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.55
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$709.21
|
| Rate for Payer: Cofinity Commercial |
$871.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$709.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Healthscope Commercial |
$911.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$709.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$759.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: PHP Commercial |
$861.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: Priority Health SBD |
$638.28
|
| Rate for Payer: UMR Bronson Commercial |
$445.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$759.86
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$884.55
|
| Rate for Payer: Aetna Commercial |
$1,156.72
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.55
|
| 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 |
$1,088.68
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$952.60
|
| Rate for Payer: Cofinity Commercial |
$1,170.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$952.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$1,224.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$952.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,020.64
|
| 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 |
$1,156.72
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$1,156.72
|
| 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 |
$884.55
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$857.34
|
| 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 |
$503.51
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,020.64
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$598.77 |
| Max. Negotiated Rate |
$1,224.77 |
| Rate for Payer: Aetna American Axle |
$884.55
|
| Rate for Payer: Aetna Commercial |
$1,156.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.55
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$1,170.33
|
| Rate for Payer: Cofinity Commercial |
$952.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$952.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Healthscope Commercial |
$1,224.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$952.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,020.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: PHP Commercial |
$1,156.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: Priority Health SBD |
$857.34
|
| Rate for Payer: UMR Bronson Commercial |
$598.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,020.64
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna American Axle |
$29.85
|
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.85
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: UMR Bronson Commercial |
$20.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.45
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna American Axle |
$29.85
|
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.93
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.45
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Mclaren Medicare |
$8.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: PACE Medicare |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$8.74
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.74
|
| Rate for Payer: UHC Exchange |
$16.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.74
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: UMR Bronson Commercial |
$16.99
|
| Rate for Payer: VA VA |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.45
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$12.36
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC IRON LEVEL
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$576.25
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$518.62 |
| Rate for Payer: Aetna American Axle |
$374.56
|
| Rate for Payer: Aetna Commercial |
$489.81
|
| Rate for Payer: Aetna Medicare |
$288.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.56
|
| Rate for Payer: BCBS Complete |
$230.50
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$495.57
|
| Rate for Payer: Cofinity Commercial |
$403.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$518.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.81
|
| Rate for Payer: PHP Commercial |
$489.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.56
|
| Rate for Payer: Priority Health SBD |
$363.04
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$213.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.19
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$576.25
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.55 |
| Max. Negotiated Rate |
$518.62 |
| Rate for Payer: Aetna American Axle |
$374.56
|
| Rate for Payer: Aetna Commercial |
$489.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.56
|
| Rate for Payer: Cash Price |
$461.00
|
| Rate for Payer: Cofinity Commercial |
$403.38
|
| Rate for Payer: Cofinity Commercial |
$495.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$518.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.81
|
| Rate for Payer: PHP Commercial |
$489.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.56
|
| Rate for Payer: Priority Health SBD |
$363.04
|
| Rate for Payer: UMR Bronson Commercial |
$253.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.19
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,637.37
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,120.44 |
| Max. Negotiated Rate |
$10,473.63 |
| Rate for Payer: Aetna American Axle |
$7,564.29
|
| Rate for Payer: Aetna Commercial |
$9,891.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,564.29
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cofinity Commercial |
$10,008.14
|
| Rate for Payer: Cofinity Commercial |
$8,146.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,146.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,309.90
|
| Rate for Payer: Healthscope Commercial |
$10,473.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,146.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,728.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,891.76
|
| Rate for Payer: PHP Commercial |
$9,891.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,564.29
|
| Rate for Payer: Priority Health SBD |
$7,331.54
|
| Rate for Payer: UMR Bronson Commercial |
$5,120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,728.03
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,637.37
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,305.83 |
| Max. Negotiated Rate |
$10,473.63 |
| Rate for Payer: Aetna American Axle |
$7,564.29
|
| Rate for Payer: Aetna Commercial |
$9,891.76
|
| Rate for Payer: Aetna Medicare |
$5,818.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,564.29
|
| Rate for Payer: BCBS Complete |
$4,654.95
|
| Rate for Payer: Cash Price |
$9,309.90
|
| Rate for Payer: Cofinity Commercial |
$10,008.14
|
| Rate for Payer: Cofinity Commercial |
$8,146.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,146.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,309.90
|
| Rate for Payer: Healthscope Commercial |
$10,473.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,146.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,728.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,891.76
|
| Rate for Payer: PHP Commercial |
$9,891.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,564.29
|
| Rate for Payer: Priority Health SBD |
$7,331.54
|
| Rate for Payer: UMR Bronson Commercial |
$4,305.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,728.03
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,457.60
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,521.34 |
| Max. Negotiated Rate |
$3,111.84 |
| Rate for Payer: Aetna American Axle |
$2,247.44
|
| Rate for Payer: Aetna Commercial |
$2,938.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,247.44
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,420.32
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,420.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,111.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,420.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,593.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: PHP Commercial |
$2,938.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health SBD |
$2,178.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,521.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.20
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,279.31 |
| Max. Negotiated Rate |
$3,111.84 |
| Rate for Payer: Aetna American Axle |
$2,247.44
|
| Rate for Payer: Aetna Commercial |
$2,938.96
|
| Rate for Payer: Aetna Medicare |
$1,728.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,247.44
|
| Rate for Payer: BCBS Complete |
$1,383.04
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,420.32
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,420.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,111.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,420.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,593.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: PHP Commercial |
$2,938.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health SBD |
$2,178.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,279.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.20
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$5,401.96
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,376.86 |
| Max. Negotiated Rate |
$4,861.76 |
| Rate for Payer: Aetna American Axle |
$3,511.27
|
| Rate for Payer: Aetna Commercial |
$4,591.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,511.27
|
| Rate for Payer: Cash Price |
$4,321.57
|
| Rate for Payer: Cofinity Commercial |
$3,781.37
|
| Rate for Payer: Cofinity Commercial |
$4,645.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,781.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,321.57
|
| Rate for Payer: Healthscope Commercial |
$4,861.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,781.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,051.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,591.67
|
| Rate for Payer: PHP Commercial |
$4,591.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,511.27
|
| Rate for Payer: Priority Health SBD |
$3,403.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,376.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,051.47
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,401.96
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,998.73 |
| Max. Negotiated Rate |
$4,861.76 |
| Rate for Payer: Aetna American Axle |
$3,511.27
|
| Rate for Payer: Aetna Commercial |
$4,591.67
|
| Rate for Payer: Aetna Medicare |
$2,700.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,511.27
|
| Rate for Payer: BCBS Complete |
$2,160.78
|
| Rate for Payer: Cash Price |
$4,321.57
|
| Rate for Payer: Cofinity Commercial |
$3,781.37
|
| Rate for Payer: Cofinity Commercial |
$4,645.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,781.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,321.57
|
| Rate for Payer: Healthscope Commercial |
$4,861.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,781.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,051.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,591.67
|
| Rate for Payer: PHP Commercial |
$4,591.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,511.27
|
| Rate for Payer: Priority Health SBD |
$3,403.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,998.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,051.47
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
OP
|
$10,281.82
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,804.27 |
| Max. Negotiated Rate |
$9,253.64 |
| Rate for Payer: Aetna American Axle |
$6,683.18
|
| Rate for Payer: Aetna Commercial |
$8,739.55
|
| Rate for Payer: Aetna Medicare |
$5,140.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,683.18
|
| Rate for Payer: BCBS Complete |
$4,112.73
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$7,197.27
|
| Rate for Payer: Cofinity Commercial |
$8,842.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,197.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$9,253.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,197.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,711.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: PHP Commercial |
$8,739.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: Priority Health SBD |
$6,477.55
|
| Rate for Payer: UMR Bronson Commercial |
$3,804.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,711.36
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$10,281.82
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,524.00 |
| Max. Negotiated Rate |
$9,253.64 |
| Rate for Payer: Aetna American Axle |
$6,683.18
|
| Rate for Payer: Aetna Commercial |
$8,739.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,683.18
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$7,197.27
|
| Rate for Payer: Cofinity Commercial |
$8,842.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,197.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$9,253.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,197.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,711.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: PHP Commercial |
$8,739.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: Priority Health SBD |
$6,477.55
|
| Rate for Payer: UMR Bronson Commercial |
$4,524.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,711.36
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
OP
|
$10,281.82
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,804.27 |
| Max. Negotiated Rate |
$9,253.64 |
| Rate for Payer: Aetna American Axle |
$6,683.18
|
| Rate for Payer: Aetna Commercial |
$8,739.55
|
| Rate for Payer: Aetna Medicare |
$5,140.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,683.18
|
| Rate for Payer: BCBS Complete |
$4,112.73
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$7,197.27
|
| Rate for Payer: Cofinity Commercial |
$8,842.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,197.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$9,253.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,197.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,711.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: PHP Commercial |
$8,739.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: Priority Health SBD |
$6,477.55
|
| Rate for Payer: UMR Bronson Commercial |
$3,804.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,711.36
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$10,281.82
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,524.00 |
| Max. Negotiated Rate |
$9,253.64 |
| Rate for Payer: Aetna American Axle |
$6,683.18
|
| Rate for Payer: Aetna Commercial |
$8,739.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,683.18
|
| Rate for Payer: Cash Price |
$8,225.46
|
| Rate for Payer: Cofinity Commercial |
$7,197.27
|
| Rate for Payer: Cofinity Commercial |
$8,842.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,197.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,225.46
|
| Rate for Payer: Healthscope Commercial |
$9,253.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,197.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,711.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,739.55
|
| Rate for Payer: PHP Commercial |
$8,739.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,683.18
|
| Rate for Payer: Priority Health SBD |
$6,477.55
|
| Rate for Payer: UMR Bronson Commercial |
$4,524.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,711.36
|
|
|
HC IR PULMONARY
|
Facility
|
OP
|
$2,010.44
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$1,306.79
|
| Rate for Payer: Aetna Commercial |
$1,708.87
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.79
|
| 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 |
$1,608.35
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cofinity Commercial |
$1,728.98
|
| Rate for Payer: Cofinity Commercial |
$1,407.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,407.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,809.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,407.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,507.83
|
| 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 |
$1,708.87
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$1,708.87
|
| 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 |
$1,306.79
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,266.58
|
| 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 |
$743.86
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,507.83
|
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$2,010.44
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$884.59 |
| Max. Negotiated Rate |
$1,809.40 |
| Rate for Payer: Aetna American Axle |
$1,306.79
|
| Rate for Payer: Aetna Commercial |
$1,708.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.79
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cofinity Commercial |
$1,407.31
|
| Rate for Payer: Cofinity Commercial |
$1,728.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,407.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.35
|
| Rate for Payer: Healthscope Commercial |
$1,809.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,407.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,507.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.87
|
| Rate for Payer: PHP Commercial |
$1,708.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.79
|
| Rate for Payer: Priority Health SBD |
$1,266.58
|
| Rate for Payer: UMR Bronson Commercial |
$884.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,507.83
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,274.69
|
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.69
|
| 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 |
$2,799.62
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$3,009.60
|
| Rate for Payer: Cofinity Commercial |
$2,449.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,449.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,449.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.65
|
| 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 |
$2,974.60
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| 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 |
$2,274.69
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,204.70
|
| 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 |
$1,294.83
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.65
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,539.79 |
| Max. Negotiated Rate |
$3,149.58 |
| Rate for Payer: Aetna American Axle |
$2,274.69
|
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.69
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$2,449.67
|
| Rate for Payer: Cofinity Commercial |
$3,009.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,449.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,449.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health SBD |
$2,204.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,539.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.65
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$123.73
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$111.36 |
| Rate for Payer: Aetna American Axle |
$80.42
|
| Rate for Payer: Aetna Commercial |
$105.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.42
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cofinity Commercial |
$106.41
|
| Rate for Payer: Cofinity Commercial |
$86.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.98
|
| Rate for Payer: Healthscope Commercial |
$111.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.17
|
| Rate for Payer: PHP Commercial |
$105.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.42
|
| Rate for Payer: Priority Health SBD |
$77.95
|
| Rate for Payer: UMR Bronson Commercial |
$54.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.80
|
|
