|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$123.73
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$111.36 |
| Rate for Payer: Aetna American Axle |
$80.42
|
| Rate for Payer: Aetna Commercial |
$105.17
|
| Rate for Payer: Aetna Medicare |
$39.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cofinity Commercial |
$86.61
|
| Rate for Payer: Cofinity Commercial |
$106.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| 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: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.17
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$105.17
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.42
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health SBD |
$77.95
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$73.16
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: VA VA |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.80
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,485.46
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$2,265.55
|
| Rate for Payer: Aetna Commercial |
$2,962.64
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,265.55
|
| 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 |
$2,788.37
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cofinity Commercial |
$2,997.50
|
| Rate for Payer: Cofinity Commercial |
$2,439.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,788.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,136.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,614.09
|
| 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 |
$2,962.64
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$2,962.64
|
| 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 |
$2,265.55
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,195.84
|
| 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 |
$1,289.62
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,614.09
|
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,485.46
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,533.60 |
| Max. Negotiated Rate |
$3,136.91 |
| Rate for Payer: Aetna American Axle |
$2,265.55
|
| Rate for Payer: Aetna Commercial |
$2,962.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,265.55
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cofinity Commercial |
$2,439.82
|
| Rate for Payer: Cofinity Commercial |
$2,997.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,788.37
|
| Rate for Payer: Healthscope Commercial |
$3,136.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,614.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,962.64
|
| Rate for Payer: PHP Commercial |
$2,962.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.55
|
| Rate for Payer: Priority Health SBD |
$2,195.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,533.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,614.09
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,850.35 |
| Max. Negotiated Rate |
$9,921.18 |
| Rate for Payer: Aetna American Axle |
$7,165.29
|
| Rate for Payer: Aetna Commercial |
$9,370.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,165.29
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cofinity Commercial |
$7,716.47
|
| Rate for Payer: Cofinity Commercial |
$9,480.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,716.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,818.82
|
| Rate for Payer: Healthscope Commercial |
$9,921.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,716.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,267.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,370.00
|
| Rate for Payer: PHP Commercial |
$9,370.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,165.29
|
| Rate for Payer: Priority Health SBD |
$6,944.82
|
| Rate for Payer: UMR Bronson Commercial |
$4,850.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,267.65
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna American Axle |
$7,165.29
|
| Rate for Payer: Aetna Commercial |
$9,370.00
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,165.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cofinity Commercial |
$9,480.24
|
| Rate for Payer: Cofinity Commercial |
$7,716.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,716.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,818.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$9,921.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,716.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,267.65
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,370.00
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$9,370.00
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,165.29
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$6,944.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$10,626.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: UMR Bronson Commercial |
$4,078.71
|
| Rate for Payer: VA VA |
$5,560.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,267.65
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna American Axle |
$7,224.50
|
| Rate for Payer: Aetna Commercial |
$9,447.42
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,224.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$9,558.56
|
| Rate for Payer: Cofinity Commercial |
$7,780.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,780.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$10,003.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,780.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,335.96
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$9,447.42
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$7,002.20
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$10,626.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: UMR Bronson Commercial |
$4,112.41
|
| Rate for Payer: VA VA |
$5,560.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,335.96
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,890.43 |
| Max. Negotiated Rate |
$10,003.15 |
| Rate for Payer: Aetna American Axle |
$7,224.50
|
| Rate for Payer: Aetna Commercial |
$9,447.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,224.50
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$7,780.23
|
| Rate for Payer: Cofinity Commercial |
$9,558.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,780.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Healthscope Commercial |
$10,003.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,780.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,335.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: PHP Commercial |
$9,447.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health SBD |
$7,002.20
|
| Rate for Payer: UMR Bronson Commercial |
$4,890.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,335.96
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,178.08 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna American Axle |
$4,694.89
|
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.89
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,056.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,056.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,417.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.89
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,178.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,417.18
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,672.47 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna American Axle |
$4,694.89
|
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna Medicare |
$3,611.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.89
|
| Rate for Payer: BCBS Complete |
$2,889.16
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,056.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,056.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,417.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.89
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,672.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,417.18
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,463.92 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna American Axle |
$8,071.69
|
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,071.69
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Cofinity Commercial |
$8,692.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,692.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,692.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health SBD |
$7,823.33
|
| Rate for Payer: UMR Bronson Commercial |
$5,463.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,594.66 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$8,071.69
|
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,071.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$8,692.59
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,692.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,692.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$7,823.33
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$4,594.66
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,071.39 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$8,909.20
|
| Rate for Payer: Aetna Commercial |
$11,650.49
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,909.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$9,594.52
|
| Rate for Payer: Cofinity Commercial |
$11,787.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,594.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$12,335.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,594.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,279.84
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$11,650.49
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$8,635.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$5,071.39
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,279.84
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,030.84 |
| Max. Negotiated Rate |
$12,335.81 |
| Rate for Payer: Aetna American Axle |
$8,909.20
|
| Rate for Payer: Aetna Commercial |
$11,650.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,909.20
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$11,787.56
|
| Rate for Payer: Cofinity Commercial |
$9,594.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,594.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Healthscope Commercial |
$12,335.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,594.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,279.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: PHP Commercial |
$11,650.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health SBD |
$8,635.07
|
| Rate for Payer: UMR Bronson Commercial |
$6,030.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,279.84
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,336.98 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna American Axle |
$4,929.63
|
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,308.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,308.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,688.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,336.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,688.03
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,806.09 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna American Axle |
$4,929.63
|
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna Medicare |
$3,792.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: BCBS Complete |
$3,033.62
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,308.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,308.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,688.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,806.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,688.03
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,579.20 |
| Max. Negotiated Rate |
$11,138.59 |
| Rate for Payer: Aetna American Axle |
$8,044.54
|
| Rate for Payer: Aetna Commercial |
$10,519.78
|
| Rate for Payer: Aetna Medicare |
$6,188.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,044.54
|
| Rate for Payer: BCBS Complete |
$4,950.48
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$10,643.54
|
| Rate for Payer: Cofinity Commercial |
$8,663.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,663.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$11,138.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,663.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,282.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: PHP Commercial |
$10,519.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health SBD |
$7,797.01
|
| Rate for Payer: UMR Bronson Commercial |
$4,579.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,282.16
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,445.53 |
| Max. Negotiated Rate |
$11,138.59 |
| Rate for Payer: Aetna American Axle |
$8,044.54
|
| Rate for Payer: Aetna Commercial |
$10,519.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,044.54
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$10,643.54
|
| Rate for Payer: Cofinity Commercial |
$8,663.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,663.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$11,138.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,663.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,282.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: PHP Commercial |
$10,519.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health SBD |
$7,797.01
|
| Rate for Payer: UMR Bronson Commercial |
$5,445.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,282.16
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,628.34 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,363.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UMR Bronson Commercial |
$4,628.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,892.01 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$7,363.27
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,363.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UMR Bronson Commercial |
$3,892.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,008.95 |
| Max. Negotiated Rate |
$10,245.58 |
| Rate for Payer: Aetna American Axle |
$7,399.59
|
| Rate for Payer: Aetna Commercial |
$9,676.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,399.59
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$7,968.79
|
| Rate for Payer: Cofinity Commercial |
$9,790.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,968.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Healthscope Commercial |
$10,245.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,968.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,537.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: PHP Commercial |
$9,676.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health SBD |
$7,171.91
|
| Rate for Payer: UMR Bronson Commercial |
$5,008.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,537.99
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna American Axle |
$7,399.59
|
| Rate for Payer: Aetna Commercial |
$9,676.38
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,399.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$9,790.22
|
| Rate for Payer: Cofinity Commercial |
$7,968.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,968.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$10,245.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,968.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,537.99
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$9,676.38
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$7,171.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$10,626.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: UMR Bronson Commercial |
$4,212.07
|
| Rate for Payer: VA VA |
$5,560.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,537.99
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$182.25
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$80.19 |
| Max. Negotiated Rate |
$164.03 |
| Rate for Payer: Aetna American Axle |
$118.46
|
| Rate for Payer: Aetna Commercial |
$154.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.46
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cofinity Commercial |
$127.58
|
| Rate for Payer: Cofinity Commercial |
$156.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.80
|
| Rate for Payer: Healthscope Commercial |
$164.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.91
|
| Rate for Payer: PHP Commercial |
$154.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.46
|
| Rate for Payer: Priority Health SBD |
$114.82
|
| Rate for Payer: UMR Bronson Commercial |
$80.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.69
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$182.25
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$164.03 |
| Rate for Payer: Aetna American Axle |
$118.46
|
| Rate for Payer: Aetna Commercial |
$154.91
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cofinity Commercial |
$156.74
|
| Rate for Payer: Cofinity Commercial |
$127.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$164.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.69
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.91
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$154.91
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.46
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$114.82
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$67.43
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.69
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$43.61
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: Aetna American Axle |
$28.35
|
| Rate for Payer: Aetna Commercial |
$37.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.35
|
| Rate for Payer: Cash Price |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$30.53
|
| Rate for Payer: Cofinity Commercial |
$37.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.89
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.07
|
| Rate for Payer: PHP Commercial |
$37.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.35
|
| Rate for Payer: Priority Health SBD |
$27.47
|
| Rate for Payer: UMR Bronson Commercial |
$19.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.71
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$43.61
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: Aetna American Axle |
$28.35
|
| Rate for Payer: Aetna Commercial |
$37.07
|
| Rate for Payer: Aetna Medicare |
$21.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.35
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: Cash Price |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$30.53
|
| Rate for Payer: Cofinity Commercial |
$37.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.89
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.07
|
| Rate for Payer: PHP Commercial |
$37.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.35
|
| Rate for Payer: Priority Health SBD |
$27.47
|
| Rate for Payer: UMR Bronson Commercial |
$16.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.71
|
|
